Simonetta Federico, Masouridi-Levrat Stavroula, Beauverd Yan, Tsopra Olga, Tirefort Yordanka, Koutsi Aikaterini, Stephan Caroline, Polchlopek-Blasiak Karolina, Pradier Amandine, Dantin Carole, Ansari Marc, Roosnek Eddy, Chalandon Yves
a Department of Oncology, Division of Hematology , Geneva University Hospitals , Geneva , Switzerland.
b Department of Pediatrics, Onco-Hematology Unit , Geneva University Hospitals , Geneva , Switzerland.
Leuk Lymphoma. 2018 Mar;59(3):590-600. doi: 10.1080/10428194.2017.1344844. Epub 2017 Jul 6.
Graft-versus-host disease (GvHD)-free, relapse-free survival (GRFS) is a recently reported composite endpoint that allows to simultaneously estimate risk of death, relapse and GvHD after allogeneic hematopoietic stem cell transplantation (HSCT). In this retrospective study comprising 333 patients transplanted for hematologic malignancies, we compared GRFS in patients receiving partial T-cell-depleted (pTCD) grafts with patients receiving T-cell-replete grafts (No-TCD). pTCD was associated with a significantly improved GRFS. The beneficial effect of pTCD on GRFS remained highly significant in multivariable analysis taking into account clinical factors differing between patient groups. We observed no effect of pTCD on overall survival, progression-free survival, and relapse cumulative incidence, while non-relapse mortality cumulative incidence was significantly lower in patients receiving pTCD. The results of our retrospective analysis suggest that pTCD could improve GRFS in allogeneic HSCT recipients without significantly affecting OS and PFS, thus improving patients' quality of life without impairing the curative potential of allogeneic HSCT.
无移植物抗宿主病(GvHD)、无复发生存期(GRFS)是最近报道的一个综合终点指标,可用于同时评估异基因造血干细胞移植(HSCT)后死亡、复发和GvHD的风险。在这项纳入333例因血液系统恶性肿瘤接受移植患者的回顾性研究中,我们比较了接受部分T细胞去除(pTCD)移植物的患者与接受T细胞充足移植物(未进行T细胞去除,No-TCD)的患者的GRFS。pTCD与显著改善的GRFS相关。在考虑患者组间不同临床因素的多变量分析中,pTCD对GRFS的有益作用仍然非常显著。我们观察到pTCD对总生存期、无进展生存期和复发累积发生率没有影响,而接受pTCD的患者非复发死亡率累积发生率显著更低。我们回顾性分析的结果表明,pTCD可改善异基因HSCT受者的GRFS,而不会显著影响总生存期和无进展生存期,从而在不损害异基因HSCT治愈潜力的情况下提高患者的生活质量。