Division of Pediatric Hematology and Oncology, Department of Pediatrics, Universities of Medical University Hannover, Hannover, Germany.
IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy.
Br J Haematol. 2020 May;189(4):745-750. doi: 10.1111/bjh.16441. Epub 2020 Feb 3.
Outcome of 333 children with acute myeloid leukaemia relapsing after a first allogeneic haematopoietic stem cell transplantation was analyzed. Four-year probability of overall survival (4y-pOS) was 14%. 4y-pOS for 122 children receiving a second haematopoietic stem cell transplantation was 31% and 3% for those that did not (P = <0·0001). Achievement of a subsequent remission impacted survival (P = <0·0001). For patients receiving a second transplant survival with or without achieving a subsequent remission was comparable. Graft source (bone marrow vs. peripheral blood stem cells, P = 0·046) and donor choice (matched family vs. matched unrelated donor, P = 0·029) positively impacted survival after relapse. Disease recurrence and non-relapse mortality at four years reached 45% and 22%.
分析了 333 例首次异基因造血干细胞移植后复发的急性髓系白血病儿童的结果。总生存 4 年的概率(4y-pOS)为 14%。接受第二次造血干细胞移植的 122 名儿童的 4y-pOS 为 31%,未接受第二次移植的为 3%(P<0.0001)。获得后续缓解对生存有影响(P<0.0001)。对于接受第二次移植的患者,无论是否获得后续缓解,其生存情况相似。移植来源(骨髓与外周血干细胞,P=0.046)和供者选择(匹配的亲缘供者与匹配的无关供者,P=0.029)对复发后的生存有积极影响。复发后 4 年疾病复发和非复发死亡率达到 45%和 22%。