Balduzzi Adriana, De Lorenzo Paola, Schrauder André, Conter Valentino, Uderzo Cornelio, Peters Christina, Klingebiel Thomas, Stary Jan, Felice Maria S, Magyarosy Edina, Schrappe Martin, Dini Giorgio, Gadner Helmut, Valsecchi Maria Grazia
Clinica Pediatrica Università degli Studi di Milano Bicocca, Ospedale San Gerardo, via Pergolesi 33, 20052 Monza, Milan, Italy.
Haematologica. 2008 Jun;93(6):925-9. doi: 10.3324/haematol.12291. Epub 2008 Apr 15.
The advantage of allogeneic transplant from compatible related donors versus chemotherapy in children with very-high-risk acute lymphoblastic leukemia in first complete remission was previously demonstrated in an international prospective trial. This study quantified the impact of time elapsed in first remission in the same cohort. Of 357 pediatric patients with very-high-risk acute lymphoblastic leukemia, 259 received chemotherapy, 55 transplantation from compatible related and 43 from unrelated donors. The 5-year disease-free survival was 44.2% overall and 42.5% for chemotherapy only patients. The chemotherapy conditional 5-year disease-free survival increased to 44.4%, 47.6%, 51.7%, and 60.4% in patients who maintained their first remission for at least 3, 6, 9, and 12 months respectively. The overall outcome was superior to that obtained with chemotherapy-only at any time-point. The relative advantage of transplant from compatible related donors in very-high-risk childhood acute lymphoblastic leukemia was consistent for any time elapsed in first remission.
在一项国际前瞻性试验中，先前已证明，对于首次完全缓解的极高危急性淋巴细胞白血病儿童，与化疗相比，来自匹配相关供者的异基因移植具有优势。本研究对同一队列中首次缓解期所经历时间的影响进行了量化。在357例极高危急性淋巴细胞白血病儿科患者中，259例接受了化疗，55例接受了来自匹配相关供者的移植，43例接受了来自无关供者的移植。总体5年无病生存率为44.2%，仅接受化疗的患者为42.5%。在分别维持首次缓解至少3、6、9和12个月的患者中，化疗条件下的5年无病生存率分别增至44.4%、47.6%、51.7%和60.4%。在任何时间点，总体结果均优于仅接受化疗的情况。对于极高危儿童急性淋巴细胞白血病，来自匹配相关供者移植的相对优势在首次缓解期所经历的任何时间都是一致的。
