不同同种异体造血干细胞移植预处理方案的比较显示，全身照射为基础的方案在年轻急性白血病患者中具有优越性：一项全国性研究。
Comparison of Different Conditioning Regimens in Allogeneic Hematopoietic Stem-Cell Transplantation Shows Superiority of Total Body Irradiation-Based Regimen for Younger Patients With Acute Leukemia: A Nationwide Study.
机构信息
Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
出版信息
Clin Lymphoma Myeloma Leuk. 2019 Nov;19(11):e605-e615. doi: 10.1016/j.clml.2019.08.005. Epub 2019 Aug 26.
BACKGROUND
The optimal the conditioning regimens for allogeneic hematopoietic stem-cell transplantation, especially for East Asian patients, remains unknown.
PATIENTS AND METHODS
We collected and analyzed clinical and survival data of 4255 patients from the Korean National Health Insurance Claims Database.
RESULTS
Between 1562 myeloablative conditioning and 2693 nonmyeloablative conditioning groups, the overall survival was not statistically different. However, in the myeloablative conditioning group, the overall survival of the total body irradiation-based regimen was better than that of chemotherapy-alone regimen (P = .005). In subgroup analysis, the superiority of the total body irradiation-based regimen was especially prominent in acute leukemia (P = .012 for acute myeloid leukemia; P = .005 for acute lymphoblastic leukemia) and for younger patients (< 50 years old vs. ≥ 50 years old, P = .015).
CONCLUSION
Total body irradiation combination might be the best conditioning regimen for young patients undergoing hematopoietic stem-cell transplantation for acute leukemias in Korea.
背景
异体造血干细胞移植的最佳预处理方案，尤其是针对东亚患者的方案，仍不明确。
患者与方法
我们从韩国国民健康保险索赔数据库中收集并分析了 4255 例患者的临床和生存数据。
结果
在 1562 例清髓性预处理和 2693 例非清髓性预处理组中，总生存率无统计学差异。然而，在清髓性预处理组中，基于全身照射的预处理方案的总生存率优于单纯化疗组（P=0.005）。在亚组分析中，基于全身照射的预处理方案的优势在急性白血病中尤为明显（急性髓系白血病，P=0.012；急性淋巴细胞白血病，P=0.005），且在年轻患者中更为显著（<50 岁 vs. ≥50 岁，P=0.015）。
结论
对于在韩国接受造血干细胞移植的急性白血病的年轻患者，全身照射联合预处理可能是最佳的预处理方案。
Zotero 插件