Department of Biopathology, University of Rome Tor Vergata, Italy.
Haematologica. 2012 Nov;97(11):1731-5. doi: 10.3324/haematol.2012.065714. Epub 2012 Jun 11.
The role of allogeneic stem cell transplant in advanced acute promyelocytic leukemia patients who received standard first- and second-line therapy is still unknown. We report the outcome of 31 acute promyelocytic leukemia patients (median age 39 years) who underwent allogeneic transplant in second remission (n=15) or beyond (n=16). Sixteen patients were real-time polymerase chain reaction positive and 15 negative for PML/RARA pre-transplant. The 4-year overall survival was 62% and 31% for patients transplanted in second remission and beyond, respectively (P=0.05), and 64% and 27% for patients with pre-transplant negative and positive real-time polymerase chain reaction, respectively (P=0.03). The 4-year cumulative incidence of relapse was 32% and 44% for patients transplanted in second remission and beyond, respectively (P=0.37), and 30% and 47% for patients transplanted with negative and positive real-time polymerase chain reaction, respectively (P=0.30). Transplant-related mortality was 19.6%. In conclusion, allogeneic transplant is effective in advanced acute promyelocytic leukemia in the all-trans-retinoic acid and arsenic trioxide era, and should be considered once relapse is diagnosed.
异基因造血干细胞移植在接受标准一线和二线治疗的晚期急性早幼粒细胞白血病患者中的作用尚不清楚。我们报告了 31 例急性早幼粒细胞白血病患者（中位年龄 39 岁）的结果，这些患者在第二次缓解（n=15）或缓解后（n=16）接受了异基因移植。16 例患者移植前 PML/RARA 实时聚合酶链反应为阳性，15 例为阴性。移植后 4 年总生存率分别为 62%和 31%（P=0.05），移植前实时聚合酶链反应阴性和阳性患者分别为 64%和 27%（P=0.03）。移植后 4 年累积复发率分别为 32%和 44%（P=0.37），移植前实时聚合酶链反应阴性和阳性患者分别为 30%和 47%（P=0.30）。移植相关死亡率为 19.6%。总之，在全反式维甲酸和三氧化二砷时代，异基因移植对晚期急性早幼粒细胞白血病是有效的，一旦确诊复发，就应考虑进行移植。
