Lee Sung-Eun, Choi Soo Young, Kim Soo-Hyun, Song Hye-Young, Yoo Hea-Lyun, Lee Mi-Young, Kang Ki-Hoon, Hwang Hee-Jeong, Jang Eun-Jung, Kim Dong-Wook
Catholic Leukemia Research Institute, The Catholic University of Korea, Seoul, Korea.
Department of Hematology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
Korean J Intern Med. 2017 Jan;32(1):125-136. doi: 10.3904/kjim.2015.187. Epub 2016 Jun 22.
BACKGROUND/AIMS: The aim of this study was to identify the role of transcript level as a predictor for post-transplant relapse and outcome in patients who underwent allogeneic stem cell transplantation (SCT) for chronic phase (CP) chronic myeloid leukemia (CML).
Of 101 patients receiving allograft in CML CP, 85 had available quantitative reverse transcriptase polymerase chain reaction data at post-transplant 3 months. These patients were divided into two groups according to molecular response (MR), defined as a transcript level ≤ 0.0032% on the international scale, at 3 months based on receiver operating characteristic curve analysis of relapse.
The 4-year overall survival and event-free survival (EFS) were 80.6% and 57.3%, respectively, and the cumulative incidence of relapse at 4 years was 29.6% after a median follow-up of 126.4 months. We performed multivariate analyses including potential variables to evaluate the early predictive role of MR at 3 months and found that MR at 3 months was associated with a higher EFS ( = 0.028) and showed a trend for a lower relapse rate ( = 0.089).
our results imply that frequent molecular monitoring and immune suppressive therapy modulation are required for patients without reduction of transcripts to this level after SCT.
背景/目的：本研究旨在确定转录水平作为接受异基因干细胞移植（SCT）治疗慢性期（CP）慢性髓性白血病（CML）患者移植后复发及预后预测指标的作用。
在101例接受CML-CP同种异体移植的患者中，85例在移植后3个月有可用的定量逆转录聚合酶链反应数据。根据基于复发的受试者工作特征曲线分析，将这些患者在3个月时按照分子反应（MR）分为两组，分子反应定义为国际标准下转录水平≤0.0032%。
中位随访126.4个月后，4年总生存率和无事件生存率（EFS）分别为80.6%和57.3%，4年复发累积发生率为29.6%。我们进行了多变量分析，纳入潜在变量以评估3个月时MR的早期预测作用，发现3个月时的MR与较高的EFS相关（P = 0.028），且复发率有降低趋势（P = 0.089）。
我们的结果表明，对于SCT后转录水平未降至该水平的患者，需要频繁进行分子监测并调整免疫抑制治疗。
