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幼稚血细胞在急性髓系白血病患者中的预后价值。

The prognostic value of hematogones in patients with acute myeloid leukemia.

机构信息

Department of Hematology, CHU Caen, Cote de Nacre Avenue, 14000, France.

Department of Biostatistics and Clinical Research, CHU Caen, Cote de Nacre Avenue, 14000, France.

出版信息

Am J Hematol. 2016 Jun;91(6):566-70. doi: 10.1002/ajh.24350. Epub 2016 Apr 13.

Abstract

In acute myeloid leukemia (AML), new prognostic tools are needed to assess the risk of relapse. Hematogones (HGs) are normal B-lymphocyte precursors that increase in hematological diseases and may influence remission duration in AML. HG detection was prospectively investigated in 262 AML patients to determine its prognostic value. Flow cytometric HG detection was performed in bone marrow aspiration after intensive chemotherapy at the time of hematological recovery. Patients with HGs in bone marrow samples had a significantly better relapse-free survival (RFS) and overall survival (OS) than patients without HGs (P = 0.0021, and P = 0.0016). Detectable HGs independently predicted RFS (HR = 0.61, 95%CI: 0.42 - 0.89, P = 0.012) and OS (HR = 0.59, 95%CI: 0.38 - 0.92, 0.019) controlling for age, ELN classification, the number of chemotherapy cycles to achieve CR, performance status, secondary AML and flow cytometric minimal residual disease (MRD). In intensively treated AML, individual determination of HGs could be useful to stratify the optimal risk-adapted therapeutic strategy after induction chemotherapy. Am. J. Hematol. 91:566-570, 2016. © 2016 Wiley Periodicals, Inc.

摘要

在急性髓系白血病 (AML) 中,需要新的预后工具来评估复发风险。造血细胞(HGs)是正常的 B 淋巴细胞前体,在血液系统疾病中增加,并且可能影响 AML 的缓解持续时间。前瞻性研究了 262 例 AML 患者的 HG 检测,以确定其预后价值。在强化化疗后血液学恢复时进行骨髓抽吸,进行流式细胞术 HG 检测。骨髓样本中存在 HG 的患者的无复发生存率(RFS)和总生存率(OS)明显优于无 HG 的患者(P=0.0021 和 P=0.0016)。可检测到的 HG 独立预测 RFS(HR=0.61,95%CI:0.42-0.89,P=0.012)和 OS(HR=0.59,95%CI:0.38-0.92,0.019),控制年龄、ELN 分类、达到 CR 的化疗周期数、表现状态、继发性 AML 和流式细胞术微小残留病(MRD)。在强化治疗的 AML 中,HG 的个体确定可能有助于分层诱导化疗后最佳风险适应的治疗策略。美国血液学杂志 91:566-570,2016。©2016 年 Wiley 期刊,Inc.

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