Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA.
Biol Blood Marrow Transplant. 2011 Dec;17(12):1841-5. doi: 10.1016/j.bbmt.2011.05.018. Epub 2011 May 27.
Complete remission (CR) is the gold standard for assessing outcomes following chemotherapy for acute myelogenous leukemia (AML). "CRp," a response criterion defined as fulfillment of all criteria for CR except platelet count recovery to ≥100 × 10(9)/L, is associated with inferior outcomes following chemotherapy. The prognostic importance of CRp before allogeneic stem cell transplantation (allo-SCT) remains unknown. We analyzed a cohort of AML (n = 334) and myelodysplastic syndrome (MDS; n = 10) patients to determine the prognostic significance of achieving CR versus CRp before allo-SCT. At time of transplantation, 266 patients were in CR (CR1 and ≥CR2) and 78 in CRp (CR1p and ≥CR2p). Median follow-up was 38 months (3-131 months). Overall survival, progression-free survival, and nonrelapse mortality (NRM) were most favorable in patients transplanted in CR (CR1 or ≥CR2) compared with CRp (CR1p or ≥CR2p). Achieving CR is therefore associated with improved posttransplantation outcomes compared with achieving CRp and is a significant prognostic factor that needs to be considered when evaluating AML/MDS patients for clinical trials and allo-SCT.
完全缓解（CR）是评估急性髓系白血病（AML）化疗后结果的金标准。“CRp”是一种反应标准，定义为满足 CR 的所有标准，但血小板计数恢复至≥100×10(9)/L 除外，与化疗后的不良结果相关。在异基因造血干细胞移植（allo-SCT）之前，CRp 的预后重要性尚不清楚。我们分析了一组 AML（n=334）和骨髓增生异常综合征（MDS；n=10）患者，以确定在 allo-SCT 之前达到 CR 与 CRp 的预后意义。在移植时，266 例患者处于 CR（CR1 和≥CR2），78 例患者处于 CRp（CR1p 和≥CR2p）。中位随访时间为 38 个月（3-131 个月）。与 CRp（CR1p 或≥CR2p）相比，移植后处于 CR（CR1 或≥CR2）的患者的总生存率、无进展生存率和非复发死亡率（NRM）最为有利。因此，与获得 CRp 相比，获得 CR 与移植后转归的改善相关，是在评估 AML/MDS 患者进行临床试验和 allo-SCT 时需要考虑的重要预后因素。
