根据治疗类型和治疗线数分析217例急性红白血病患者的临床结局：一项回顾性多国研究
Clinical Outcomes of 217 Patients with Acute Erythroleukemia According to Treatment Type and Line: A Retrospective Multinational Study.
作者信息
Almeida Antonio M, Prebet Thomas, Itzykson Raphael, Ramos Fernando, Al-Ali Haifa, Shammo Jamile, Pinto Ricardo, Maurillo Luca, Wetzel Jaime, Musto Pellegrino, Van De Loosdrecht Arjan A, Costa Maria Joao, Esteves Susana, Burgstaller Sonja, Stauder Reinhard, Autzinger Eva M, Lang Alois, Krippl Peter, Geissler Dietmar, Falantes Jose Francisco, Pedro Carmen, Bargay Joan, Deben Guillermo, Garrido Ana, Bonanad Santiago, Diez-Campelo Maria, Thepot Sylvain, Ades Lionel, Sperr Wolfgang R, Valent Peter, Fenaux Pierre, Sekeres Mikkael A, Greil Richard, Pleyer Lisa
机构信息
Instituto Português de Oncologia de Lisboa (IPOL), 1200-795 Lisbon, Portugal.
Institut Paoli Calmettes, Marseille, France and Yale New Haven Hospital, New Haven, CT 06512, USA.
出版信息
Int J Mol Sci. 2017 Apr 14;18(4):837. doi: 10.3390/ijms18040837.
Acute erythroleukemia (AEL) is a rare disease typically associated with a poor prognosis. The median survival ranges between 3-9 months from initial diagnosis. Hypomethylating agents (HMAs) have been shown to prolong survival in patients with myelodysplastic syndromes (MDS) and AML, but there is limited data of their efficacy in AEL. We collected data from 210 AEL patients treated at 28 international sites. Overall survival (OS) and PFS were estimated using the Kaplan-Meier method and the log-rank test was used for subgroup comparisons. Survival between treatment groups was compared using the Cox proportional hazards regression model. Eighty-eight patients were treated with HMAs, 44 front line, and 122 with intensive chemotherapy (ICT). ICT led to a higher overall response rate (complete or partial) compared to first-line HMA (72% vs. 46.2%, respectively; ≤ 0.001), but similar progression-free survival (8.0 vs. 9.4 months; = 0.342). Overall survival was similar for ICT vs. HMAs (10.5 vs. 13.7 months; = 0.564), but patients with high-risk cytogenetics treated with HMA first-line lived longer (7.5 for ICT vs. 13.3 months; = 0.039). Our results support the therapeutic value of HMA in AEL.
急性红白血病（AEL）是一种罕见疾病，通常预后较差。从初次诊断起，中位生存期在3至9个月之间。已证明去甲基化药物（HMA）可延长骨髓增生异常综合征（MDS）和急性髓系白血病（AML）患者的生存期，但关于其在AEL中疗效的数据有限。我们收集了在28个国际中心接受治疗的210例AEL患者的数据。采用Kaplan-Meier方法估计总生存期（OS）和无进展生存期（PFS），并使用对数秩检验进行亚组比较。使用Cox比例风险回归模型比较治疗组之间的生存期。88例患者接受了HMA治疗，44例为一线治疗，122例接受了强化化疗（ICT）。与一线HMA相比，ICT导致更高的总缓解率（完全或部分缓解）（分别为72%对46.2%；P≤0.001），但无进展生存期相似（8.0个月对9.4个月；P = 0.342）。ICT与HMA的总生存期相似（10.5个月对13.7个月；P = 0.564），但一线接受HMA治疗的高危细胞遗传学患者生存期更长（ICT为7.5个月对13.3个月；P = 0.039）。我们的结果支持HMA在AEL中的治疗价值。
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