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异基因造血干细胞移植前基于血细胞计数恢复的完全缓解对急性髓系白血病患者生存的影响

Impact of Blood Count Recovery-based Complete Remission Before Allogeneic Hematopoietic Stem Cell Transplantation on Survival in Patients With Acute Myeloid Leukemia.

作者信息

Ciftciler Rafiye, Demiroglu Haluk, Buyukasık Yahya, Aksu Salih, Goker Hakan

机构信息

Department of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Department of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

出版信息

Clin Lymphoma Myeloma Leuk. 2019 May;19(5):e205-e212. doi: 10.1016/j.clml.2018.12.006. Epub 2018 Dec 21.

Abstract

BACKGROUND

Patients who achieve complete remission (CR) with incomplete blood count recovery (CRi) in acute myeloid leukemia (AML) have inferior overall survival and lower progression-free survival. The aim of this study was to define whether blood count recovery-based CR before allogeneic hematopoietic stem cell transplantation (alloHSCT) had an impact on survival in patients with AML.

MATERIALS AND METHODS

This study has been performed in a retrospective manner. One hundred one patients with AML who received an alloHSCT in our transplant center at Hacettepe University Hospital between the years 2001 and 2018 were evaluated. CRi were defined as bone marrow CR with absolute neutrophil count < 1000/mm and/or platelet count < 100.000/mm. CR and CRi were confirmed just before alloHSCT in bone marrow and peripheral blood, respectively.

RESULTS

A total of 101 patients were entered into the study between 2001 and 2018. Median follow-up for all survivors was 38 months (range, 6-220 months). The 5-year overall survival for patients who were in CRi and patients who were in CR before transplantation were 58% and 67%, respectively (P = .68). The 5-year progression-free survival for patients who were in CRi and patients who were in CR before transplantation were 68% and 64%, respectively (P = .99).

CONCLUSION

In conclusion, we observed equivalent posttransplant outcomes between patients who were in CR and patients who were in CRi before alloHSCT. We assume that alloHSCT eliminated the negative effect of pre-transplant blood count levels.

摘要

背景

急性髓系白血病(AML)患者实现完全缓解(CR)但血细胞计数未完全恢复(CRi),其总生存期较差,无进展生存期较低。本研究的目的是确定异基因造血干细胞移植(alloHSCT)前基于血细胞计数恢复的CR是否对AML患者的生存有影响。

材料与方法

本研究采用回顾性研究方法。对2001年至2018年间在哈杰泰佩大学医院移植中心接受alloHSCT的101例AML患者进行了评估。CRi定义为骨髓CR且绝对中性粒细胞计数<1000/mm³和/或血小板计数<100,000/mm³。CR和CRi分别在alloHSCT前在骨髓和外周血中得到确认。

结果

2001年至2018年间共有101例患者纳入研究。所有幸存者的中位随访时间为38个月(范围6 - 220个月)。移植前处于CRi的患者和处于CR的患者的5年总生存率分别为58%和67%(P = 0.68)。移植前处于CRi的患者和处于CR的患者的5年无进展生存率分别为68%和64%(P = 0.99)。

结论

总之,我们观察到alloHSCT前处于CR的患者和处于CRi的患者移植后结果相当。我们推测alloHSCT消除了移植前血细胞计数水平的负面影响。

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