移植物抗宿主病影响急性淋巴细胞白血病/淋巴瘤异基因造血干细胞移植后的总生存期。
Graft host disease impacts overall survival post allogeneic hematopoietic stem cell transplantation for acute lymphoblastic leukemia/lymphoma.
作者信息
Damlaj Moussab, Snnallah Mohammad, Alhejazi Ayman, Ghazi Samer, Alahmari Bader, Alaskar Ahmed, Al-Zahrani Mohsen
机构信息
Division of Hematology and HCT, Department of Oncology, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia.
出版信息
World J Transplant. 2018 Nov 30;8(7):252-261. doi: 10.5500/wjt.v8.i7.252.
AIM
To examine the outcome and prognostic factors for high risk patients with acute lymphoblastic leukemia/lymphoma (ALL/LBL) who underwent allogeneic hematopoietic stem cell transplantation (HCT) at our center during the period of 2010-2017.
METHODS
After due institutional review board approval, patients with high risk ALL/LBL post HCT were identified and included. All records were retrospectively collected. Time to event analysis was calculated from the date of HCT until event of interest or last follow up with Kaplan-Meir means. Cox regression model was used for multivariable analysis calculation.
RESULTS
A total of 69 patients were enrolled and examined with a median age of 21 (14-61). After a median follow up of 15 mo (2-87.3), the 2-year cumulative incidence of relapse, cumulative incidence of non-relapse mortality, progression free survival and overall survival (OS) were 34.1%, 10.9%, 54.9% and 62.8%, respectively. In a multivariable analysis for OS; acute graft host disease (GVHD) and chronic GVHD were significant with corresponding hazard ratio 4.9 (1.99-12; = 0.0007) and 0.29 (0.1-0.67; = 0.0044), respectively.
CONCLUSION
Allogeneic-HCT for high risk ALL/LBL resulted in promising remissions particularly for patients with cGVHD.
目的
研究2010年至2017年期间在本中心接受异基因造血干细胞移植（HCT）的高危急性淋巴细胞白血病/淋巴瘤（ALL/LBL）患者的结局及预后因素。
方法
经机构审查委员会批准后，确定并纳入HCT术后的高危ALL/LBL患者。所有记录均进行回顾性收集。从HCT日期至感兴趣事件或最后一次随访，采用Kaplan-Meir法计算事件发生时间分析。采用Cox回归模型进行多变量分析计算。
结果
共纳入69例患者进行检查，中位年龄为21岁（14 - 61岁）。中位随访15个月（2 - 87.3个月）后，2年累积复发率、非复发死亡率累积发生率、无进展生存期和总生存期（OS）分别为34.1%、10.9%、54.9%和62.8%。在OS的多变量分析中；急性移植物抗宿主病（GVHD）和慢性GVHD具有显著性，相应的风险比分别为4.9（1.99 - 12；P = 0.0007）和0.29（0.1 - 0.67；P = 0.0044）。
结论
异基因HCT治疗高危ALL/LBL取得了有前景的缓解效果，尤其是对于慢性GVHD患者。
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