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≥70岁的高危骨髓增生异常综合征和急性髓系白血病患者当代队列中的异基因移植结果。

Allogeneic transplantation outcomes amongst a contemporary cohort of high-risk myelodysplastic syndrome and acute myeloid leukemia patients aged ≥70 years.

作者信息

Lachowiez Curtis, Cook Rachel J, Hayes-Lattin Brandon, Maziarz Richard T, Borate Uma, Traer Elie, Leonard Jessica, Newell Laura, Dao Kim-Hien, Meyers Gabrielle

机构信息

Department of Medicine, Oregon Health and Science University, Portland, OR, USA.

Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA.

出版信息

Hematol Oncol Stem Cell Ther. 2019 Jun;12(2):105-109. doi: 10.1016/j.hemonc.2019.01.002. Epub 2019 Mar 2.

Abstract

Allogeneic hematopoietic stem cell transplantation (HSCT) is an integral therapy for patients with hematological malignancies, myelodysplasia, and bone marrow failure. Its use has been increasing over the past decade, as understanding of the treatment and its related toxicities has led to changes in patient selection, conditioning regimens, and post-transplant care. Older (age ≥65 years) patients are often considered unfit for transplantation; however, more recent data suggest that older patients, when selected appropriately, tolerate transplantation well. We report our institutional experience with HSCT in patients aged ≥70 years. A cohort of 22 patients underwent HSCT. Median overall survival was 5.16 years [95% confidence interval (CI): 1.5-8.7 years], and median post-transplant survival was 2.2 years (myelodysplastic syndrome: median 1.3 years, 95% CI: 4.7 months-2.2 years; acute myeloid leukemia: median not reached). Thirty-day mortality following HSCT was 9.5% (n = 2). These data provide further support for the use of HSCT in selected older patients, and highlight the impact of HSCT on overall survival among a patient cohort primarily of acute myeloid leukemia and myelodysplasia.

摘要

异基因造血干细胞移植(HSCT)是治疗血液系统恶性肿瘤、骨髓增生异常综合征和骨髓衰竭患者的重要疗法。在过去十年中,随着对该治疗及其相关毒性的认识促使患者选择、预处理方案和移植后护理发生了变化,其应用一直在增加。老年(年龄≥65岁)患者通常被认为不适合进行移植;然而,最近的数据表明,老年患者如果选择得当,对移植的耐受性良好。我们报告了我们机构对年龄≥70岁患者进行HSCT的经验。一组22例患者接受了HSCT。总生存期中位数为5.16年[95%置信区间(CI):1.5 - 8.7年],移植后生存期中位数为2.2年(骨髓增生异常综合征:中位数1.3年,95%CI:4.7个月 - 2.2年;急性髓系白血病:中位数未达到)。HSCT后30天死亡率为9.5%(n = 2)。这些数据为在选定的老年患者中使用HSCT提供了进一步支持,并突出了HSCT对主要为急性髓系白血病和骨髓增生异常综合征患者队列总体生存的影响。

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