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成人费城染色体阴性急性淋巴细胞白血病缓解期造血干细胞移植:欧洲成人急性淋巴细胞白血病工作组(EWALL)和欧洲血液和骨髓移植学会急性白血病工作组(EBMT)的立场声明。

Hematopoietic stem cell transplantation for adults with Philadelphia chromosome-negative acute lymphoblastic leukemia in first remission: a position statement of the European Working Group for Adult Acute Lymphoblastic Leukemia (EWALL) and the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT).

机构信息

Maria Sklodowska-Curie Institute-Cancer Center, Gliwice Branch, Gliwice, Poland.

University Hospitals Bristol National Health Service Foundation Trust, Bristol, UK.

出版信息

Bone Marrow Transplant. 2019 Jun;54(6):798-809. doi: 10.1038/s41409-018-0373-4. Epub 2018 Nov 1.

Abstract

Allogeneic hematopoietic stem cell transplantation (HSCT) in first complete remission is a standard of care for adult patients with Philadelphia chromosome (Ph)-negative acute lymphoblastic leukemia (ALL) and high risk of relapse. However, the stratification systems vary among study groups. Inadequate response at the level of minimal residual disease is the most commonly accepted factor indicating the need for alloHSCT. In this consensus paper on behalf of the European Working Group for Adult Acute Lymphoblastic Leukemia and the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation, we summarize available evidence and reflect current clinical practice in major European study groups regarding both indications for HSCT and particular aspects of the procedure including the choice of donor, source of stem cells and conditioning. Finally, we propose recommendations for daily clinical practice as well as for planning of prospective trials.

摘要

异基因造血干细胞移植(HSCT)在完全缓解 1 期是伴有费城染色体(Ph)阴性的成人急性淋巴细胞白血病(ALL)和高复发风险患者的标准治疗方法。然而,各研究组的分层系统存在差异。微小残留病灶水平的反应不足是最常被接受的需要 alloHSCT 的指征。在这份代表欧洲成人急性淋巴细胞白血病工作组和欧洲血液和骨髓移植学会急性白血病工作组的共识文件中,我们总结了现有证据,并反映了主要欧洲研究组在 HSCT 适应证以及包括供者选择、干细胞来源和预处理在内的具体操作方面的当前临床实践。最后,我们提出了针对日常临床实践以及前瞻性试验规划的建议。

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