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儿童急性髓系白血病首次异基因造血干细胞移植后复发的结局:333 例回顾性 I-BFM 分析。

Outcome of children relapsing after first allogeneic haematopoietic stem cell transplantation for acute myeloid leukaemia: a retrospective I-BFM analysis of 333 children.

机构信息

Division of Pediatric Hematology and Oncology, Department of Pediatrics, Universities of Medical University Hannover, Hannover, Germany.

IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy.

出版信息

Br J Haematol. 2020 May;189(4):745-750. doi: 10.1111/bjh.16441. Epub 2020 Feb 3.

Abstract

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%.

摘要

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%。

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