接受化疗和干细胞移植与单纯化疗的混合表型急性白血病患者的疗效比较。
Comparison of outcomes in mixed phenotype acute leukemia patients treated with chemotherapy and stem cell transplantation versus chemotherapy alone.
作者信息
Tian Hong, Xu Yang, Liu Liming, Yan Lingzhi, Jin Zhengming, Tang Xiaowen, Han Yue, Fu Zhengzheng, Qiu Huiying, Sun Aining, Wu Depei
机构信息
Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, China; Collaborative Innovation Center of Hematology, Soochow University, 188 Shizi Street, Suzhou 215006, China; Suzhou Institute of Blood and Marrow Transplantation, 188 Shizi Street, Suzhou 215006, China.
Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, China; Collaborative Innovation Center of Hematology, Soochow University, 188 Shizi Street, Suzhou 215006, China; Suzhou Institute of Blood and Marrow Transplantation, 188 Shizi Street, Suzhou 215006, China.
出版信息
Leuk Res. 2016 Jun;45:40-6. doi: 10.1016/j.leukres.2016.04.002. Epub 2016 Apr 4.
The optimal treatment approach for mixed phenotype acute leukemia (MPAL) remains unknown, and prognostic factors for treatment outcomes need to be identified. In this study, 66 patients diagnosed with MPAL according to criteria published by the WHO in 2008 were retrospectively assessed to evaluate the effectiveness of treatment and identify predictive variables. Five patients died of severe infection after the first induction chemotherapy, 29 received alloHSCT after induction (HSCT group), and 32 received only chemotherapy (chemotherapy group). The 3-year OS and DFS estimates for the entire cohort were 45% and 38%, respectively, and the 3-year OS differed significantly between the HSCT and chemotherapy-only groups (77% versus 16%). Using multivariate analyses, we identified disease burden as a prognostic factor for transplantation outcome, with the 3-year OS being 80% among patients who achieved remission and only 45% among patients in cases of nonremission. Our results indicate that alloHSCT after chemotherapy offers a survival advantage compared with chemotherapy only, and patients in remission before transplantation may experience a better outcome.
混合表型急性白血病（MPAL）的最佳治疗方法尚不清楚，需要确定治疗结果的预后因素。在本研究中，对66例根据世界卫生组织2008年发布的标准诊断为MPAL的患者进行回顾性评估，以评估治疗效果并确定预测变量。5例患者在首次诱导化疗后死于严重感染，29例在诱导后接受异基因造血干细胞移植（HSCT组），32例仅接受化疗（化疗组）。整个队列的3年总生存率（OS）和无病生存率（DFS）估计分别为45%和38%，HSCT组和单纯化疗组的3年OS有显著差异（77%对16%）。通过多变量分析，我们确定疾病负担是移植结果的一个预后因素，缓解患者的3年OS为80%，未缓解患者的3年OS仅为45%。我们的结果表明，化疗后进行异基因造血干细胞移植比单纯化疗具有生存优势，移植前缓解的患者可能有更好的预后。
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