Cao Y G, Jiang E L, He Y, Wei J L, Zhang R L, Huang Y, Yang D L, Ma Q L, Feng S Z, Han M Z
Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
Zhonghua Xue Ye Xue Za Zhi. 2016 Jun 14;37(6):464-8. doi: 10.3760/cma.j.issn.0253-2727.2016.06.005.
To evaluate the outcome of patients with acute myeloid leukemia (AML) received autologous hematopoietic stem cell transplantation (APBSCT) in complete remission (CR), and to study the prognostic factors.
55 cases of AML who underwent APBSCT in CR between 2008 and 2014 were retrospectively investigated. Major end points of study included overall survival (OS), disease free survival (DFS), relapse rate and transplantation related mortality.
The median follow-up time was 1 091(20-3 024) days after transplantation. The 3-year OS and DFS rates were 77.1% (95%CI 71.2%-83.8%), 73.7% (95%CI 67.2%-80.3%), respectively. 3-year DFS for patients needed less than 200 days to attain minimal residual disease (MRD) ≤0.03% was significantly higher than that of patients required 200 days or more (88.9% vs 46.9%, P=0.042). 3-year DFS for patients with constant MRD negative 90.0% was greater than that of the remaining group 61.1% , but the difference was insignificant (P=0.090). A multivariate analysis of risk factors for relapse identified days from diagnosis to MRD negative was the only independent factor [RR=0.022 (95% CI 0.001-0.604), P=0.024].
The results suggested that most AML patients in CR obtained long-term DFS after APBSCT, and continuous monitoring minimal residual disease could be used to evaluate whether adult AML patients should receive APBSCT or not.
评估急性髓系白血病(AML)患者在完全缓解(CR)期接受自体造血干细胞移植(APBSCT)的疗效,并研究预后因素。
回顾性调查2008年至2014年间55例处于CR期接受APBSCT的AML患者。研究的主要终点包括总生存期(OS)、无病生存期(DFS)、复发率和移植相关死亡率。
移植后中位随访时间为1091(20 - 3024)天。3年OS率和DFS率分别为77.1%(95%CI 71.2% - 83.8%)、73.7%(95%CI 67.2% - 80.3%)。达到微小残留病(MRD)≤0.03%所需时间少于200天的患者3年DFS显著高于需要200天或更长时间的患者(88.9%对46.9%,P = 0.042)。MRD持续阴性的患者3年DFS为90.0%,高于其余组的61.1%,但差异无统计学意义(P = 0.090)。复发危险因素的多因素分析确定从诊断到MRD阴性的天数是唯一独立因素[RR = 0.022(95%CI 0.001 - 0.604),P = 0.024]。
结果表明大多数处于CR期的AML患者在APBSCT后获得长期DFS,持续监测微小残留病可用于评估成年AML患者是否应接受APBSCT。