Peffault de Latour R, Labopin M, Cornelissen J, Vigouroux S, Craddock C, Blaise D, Huyn A, Vindelov L, Maertens J, Chevallier P, Fegueux N, Socié G, Cahn J Y, Petersen E, Schouten H, Lioure B, Russell N, Corral L L, Ciceri F, Nagler A, Mohty M
Service d'Hématologie Greffe, AP-HP-Hôpital Saint Louis, Paris, France.
Paris Diderot University, EA 3518, Paris, France.
Bone Marrow Transplant. 2015 Nov;50(11):1411-5. doi: 10.1038/bmt.2015.180. Epub 2015 Sep 14.
Allogeneic hematopoietic transplantation is increasingly used in patients aged 55 years or more with AML. The question of whether outcomes can be improved with an allele-level 8/8 HLA-matched unrelated donor (MUD) rather than an older HLA-matched sibling (MSD, more than 55 years) is still unanswered. We thus analyzed outcomes in 714 patients aged 55 years and older with AML in first CR (CR1) who received PBSCs after a reduced-intensity conditioning hematopoietic cell transplant from a MUD (n=310) or a MSD (n=404) in a recent period (2005-2010). The 3-year cumulative incidences (CIs) of non-relapse mortality were 17% and 23% with MSD and MUD, respectively (P=0.17). The 3-year CIs of relapse were 37% and 30%, respectively (P=0.12), resulting in a 3-year CI of leukemia-free survival of 46% and 47%, respectively (P=0.51). The 3-year overall survival was 49% with both MSD and MUD. In conclusion, HLA-identical sibling donors aged 55 years or more should not be excluded because of age for patients aged 55 years and older with AML in CR1.
异基因造血移植越来越多地应用于55岁及以上的急性髓系白血病（AML）患者。与年龄较大（超过55岁）的HLA匹配同胞供者（MSD）相比，等位基因水平8/8 HLA匹配的无关供者（MUD）能否改善治疗结果这一问题仍未得到解答。因此，我们分析了近期（2005 - 2010年）714例年龄在55岁及以上、处于首次完全缓解（CR1）的AML患者的治疗结果，这些患者在接受减低强度预处理造血细胞移植后接受了外周血干细胞移植，其中310例来自MUD，404例来自MSD。MSD和MUD的3年非复发死亡率累积发生率（CI）分别为17%和23%（P = 0.17）。3年复发CI分别为37%和30%（P = 0.12），导致3年无白血病生存率CI分别为46%和47%（P = 0.51）。MSD和MUD的3年总生存率均为49%。总之，对于处于CR1的55岁及以上AML患者，不应因年龄原因排除55岁及以上的HLA相同同胞供者。
