高剂量阿糖胞苷化疗（≥4g/m/天）在前体非 BCR-ABL1 急性髓系白血病首次完全缓解后进行异基因造血干细胞移植。
High-dose cytarabine chemotherapy (≥4 g/m/day) before allogeneic hematopoietic stem cell transplantation for non-core-binding-factor AML in the first complete remission.
机构信息
Department of Hematology/Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Hematology, Kobe Medical Center General Hospital, Kobe, Japan.
出版信息
Leuk Lymphoma. 2020 Dec;61(13):3128-3136. doi: 10.1080/10428194.2020.1805112. Epub 2020 Aug 17.
Benefit of high-dose cytarabine (HD-AraC) for acute myeloid leukemia (AML) prior to allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains unknown. We retrospectively analyzed data from 79 non-core-binding-factor AML patients who underwent allo-HSCT in their first complete remission (CR1). In univariate analysis, HD-AraC (≥4 g/m/day) before allo-HSCT improved disease-free survival (DFS) ( = .018), overall survival (OS) ( = .029), and cumulative incidence of relapse (CIR) ( = .033). Four-year DFS, OS, and CIR of patients receiving and not receiving HD-AraC were 79% vs. 49%, 82% vs. 56%, and 18% vs. 42%, respectively. In multivariate analysis, HD-AraC was a positive prognostic factor for DFS (hazard ratio (HR) = 0.36, 95% confidence interval (CI): 0.14-0.88), OS (HR = 0.37, 95% CI: 0.14-0.99), and CIR (HR = 0.38, 95% CI; 0.14-1.0). Our study demonstrates that HD-AraC before allo-HSCT at a dose ≥4 g/m/day is effective for treating AML patients in CR1.
在异基因造血干细胞移植（allo-HSCT）前接受高剂量阿糖胞苷（HD-AraC）治疗急性髓系白血病（AML）的益处尚不清楚。我们回顾性分析了 79 例在首次完全缓解（CR1）期接受 allo-HSCT 的非核心结合因子 AML 患者的数据。在单因素分析中，allo-HSCT 前接受 HD-AraC（≥4g/m/day）可改善无病生存（DFS）（=0.018）、总生存（OS）（=0.029）和复发累积发生率（CIR）（=0.033）。接受和未接受 HD-AraC 的患者的 4 年 DFS、OS 和 CIR 分别为 79%比 49%、82%比 56%和 18%比 42%。在多因素分析中，HD-AraC 是 DFS（风险比（HR）=0.36，95%置信区间（CI）：0.14-0.88）、OS（HR=0.37，95%CI：0.14-0.99）和 CIR（HR=0.38，95%CI：0.14-1.0）的阳性预后因素。我们的研究表明，allo-HSCT 前接受≥4g/m/day 的 HD-AraC 治疗 CR1 期 AML 患者是有效的。
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