Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital & Institute of Hematology, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, PR China.
Affiliated Hospital of The Academy of Military Medical Sciences, Beijing, PR China.
Cancer Lett. 2018 Dec 1;438:63-75. doi: 10.1016/j.canlet.2018.08.030. Epub 2018 Sep 11.
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an important curative therapy for patients with leukemia. However, relapse remains the leading cause of death after transplantation. In recent years, substantial progress has been made by Chinese physicians in the field of establishment of novel transplant modality, patient selection, minimal residual disease (MRD) monitoring, and immunological therapies, such as modified donor lymphocyte infusion (DLI) and chimeric antigen receptor T (CART) cells, as well as MRD-directed intervention for relapse. Most of these unique systems are distinct from those in the Western world. In this consensus, we reviewed the efficacy of post-HSCT relapse management practice from available Chinese studies on behalf of the HSCT workgroup of the Chinese Society of Hematology, Chinese Medical Association, and compared these studies withthe consensus or guidelines outside China. We summarized the consensus on routine practices of post-HSCT relapse management in China and focused on the recommendations of MRD monitoring, risk stratification directed strategies, and modified DLI system. This consensus will likely contribute to the standardization of post-HSCT relapse management in China and become an inspiration for further international cooperation to refine global practices.
异基因造血干细胞移植（allo-HSCT）是白血病患者重要的根治性治疗方法。然而，移植后复发仍然是导致患者死亡的主要原因。近年来，中国医生在建立新型移植模式、患者选择、微小残留病（MRD）监测、免疫治疗（如改良供者淋巴细胞输注（DLI）和嵌合抗原受体 T（CART）细胞），以及针对复发的 MRD 导向干预等领域取得了重大进展。这些独特的系统大多数与西方世界的系统不同。本共识代表中华医学会血液学分会 HSCT 工作组，基于中国 allo-HSCT 后复发管理实践的研究，回顾了allo-HSCT 后复发管理的疗效，并与中国以外的共识或指南进行了比较。我们总结了中国 allo-HSCT 后复发管理的常规实践共识，重点介绍了 MRD 监测、风险分层指导策略和改良 DLI 系统的建议。本共识可能有助于中国 allo-HSCT 后复发管理的规范化，并为进一步的国际合作提供灵感，以完善全球实践。
