Yanada Masamitsu, Mizuno Shohei, Yamasaki Satoshi, Harada Kaito, Konuma Takaaki, Tamaki Hiroya, Shingai Naoki, Uchida Naoyuki, Ozawa Yukiyasu, Tanaka Masatsugu, Onizuka Makoto, Sawa Masashi, Nakamae Hirohisa, Shiratori Souichi, Matsuoka Ken-Ichi, Eto Tetsuya, Kawakita Toshiro, Maruyama Yumiko, Ichinohe Tatsuo, Kanda Yoshinobu, Atsuta Yoshiko, Aoki Jun, Yano Shingo
Aichi Cancer Center, Nagoya, Japan.
Aichi Medical University, Nagakute, Japan.
Leuk Lymphoma. 2021 Dec;62(14):3411-3419. doi: 10.1080/10428194.2021.1961242. Epub 2021 Aug 4.
To evaluate whether outcomes following allogeneic hematopoietic cell transplantation differ according to disease type, a three-way comparison for patients with de novo acute myeloid leukemia (AML) ( = 3318), AML evolving from myelodysplastic syndromes (MDS) ( = 208), and MDS with excess blasts (MDS-EB) ( = 994) was performed. The 5-year probabilities of overall survival (OS) for de novo AML, AML evolving from MDS, and MDS-EB were 60%, 42%, and 41% ( < 0.001), respectively. Multivariate analysis revealed that, compared to de novo AML, AML evolving from MDS was associated with a higher risk of NRM ( = 0.030) and MDS-EB with a higher risk of relapse ( < 0.001), both leading to lower OS ( = 0.010 and < 0.001, respectively). These findings demonstrate inter-disease differences in post-transplant outcomes and highlight the needs to reduce NRM for AML evolving from MDS and to reduce relapse for MDS-EB.
为评估异基因造血细胞移植后的结局是否因疾病类型而异，对初发急性髓系白血病（AML）患者（n = 3318）、由骨髓增生异常综合征（MDS）演变而来的AML患者（n = 208）和原始细胞增多的MDS（MDS-EB）患者（n = 994）进行了三方比较。初发AML、由MDS演变而来的AML和MDS-EB的5年总生存（OS）概率分别为60%、42%和41%（P < 0.001）。多变量分析显示，与初发AML相比，由MDS演变而来的AML发生非复发死亡率（NRM）的风险更高（P = 0.030），而MDS-EB复发风险更高（P < 0.001），两者均导致较低的OS（分别为P = 0.010和P < 0.001）。这些发现证明了移植后结局存在疾病间差异，并突出了降低由MDS演变而来的AML的NRM以及降低MDS-EB复发率的必要性。
