Department of Hematology, Aerospace Center Hospital, Beijing, China.
J Clin Lab Anal. 2021 Oct;35(10):e23974. doi: 10.1002/jcla.23974. Epub 2021 Aug 25.
We retrospectively analyzed data from 197 patients with refractory or relapsed acute myeloid leukemia (r/rAML) who underwent allo-HCT between January 2013 and February 2020 in our center (patients with promyelocytic leukemia were excluded). Of all patients, 86 achieved a complete morphological remission (CR) before transplant, while 111 failed to do so (NR). In the CR group, 32 patients displayed minimal residual disease (MRD-positive). According to their immunophenotype pre-HCT, we divided the MRD-positive group and NR group into three subgroups: MRD 0+ group (without any antigen abnormal expression of CD7+, CD56+, CD38-, or HLA-DR-) 28 patients, MRD 1+ group (with one abnormal antigen expression of CD7+, CD56+, CD38-, or HLA-DR-) 63 patients, MRD 2+ group (with two or more abnormal antigens expression of CD7+, CD56+, CD38-, or HLA-DR-) 52 patients. 3-year estimates of disease-free survival (DFS) for MRD 0+, MRD 1+ and MRD 2+ patients were 59.5 ± 9.5%, 29.9 ± 6.1%, and 9.4 ± 5.1%, and 3-year estimates of overall survival (OS) were 59.5 ± 9.5%, 34.5 ± 6.3%, and 14.5 ± 10.8%, respectively. Multivariate analysis adjusted for genetic risk, blast cell level, secondary disease, age, sex, and donor relationship pre-HCT, the hazard ratios of abnormal expression of CD7+, CD56+, HLA-DR-, and CD38 were 6.69 (range 2.08-21.52; p = 0.001) for DFS, 2.24 (range 1.21-4.14; p = 0.010) for OS, and 7.18 (range 2.23-23.10; p = 0.001) for relapse compared with CD7-, CD56-, HLA-DR+, and CD38+ patients. Our finding suggested that abnormal expression of CD7+, CD56+, HLA-DR-, and CD38- is associated with poor outcomes, and the more number of abnormal antigens expression predict worse outcomes.
我们回顾性分析了 2013 年 1 月至 2020 年 2 月期间在我院接受异基因造血干细胞移植（allo-HCT）的 197 例难治/复发急性髓系白血病（r/rAML）患者的数据（排除早幼粒细胞白血病患者）。所有患者中，86 例在移植前达到完全形态学缓解（CR），111 例未达到（NR）。在 CR 组中，32 例患者存在微小残留病（MRD）阳性。根据患者移植前的免疫表型，我们将 MRD 阳性组和 NR 组分为三组：MRD0+组（无任何抗原异常表达 CD7+、CD56+、CD38-或 HLA-DR-）28 例，MRD1+组（CD7+、CD56+、CD38-或 HLA-DR-中有一种抗原异常表达）63 例，MRD2+组（CD7+、CD56+、CD38-或 HLA-DR-中有两种或两种以上抗原异常表达）52 例。MRD0+、MRD1+和 MRD2+患者的 3 年无病生存（DFS）估计值分别为 59.5%±9.5%、29.9%±6.1%和 9.4%±5.1%，3 年总生存（OS）估计值分别为 59.5%±9.5%、34.5%±6.3%和 14.5%±10.8%。多变量分析调整了遗传风险、原始细胞水平、继发疾病、年龄、性别和移植前供体关系，CD7+、CD56+、HLA-DR-和 CD38 异常表达的危险比（HR）分别为 6.69（范围 2.08-21.52；p=0.001）、2.24（范围 1.21-4.14；p=0.010）和 7.18（范围 2.23-23.10；p=0.001），与 CD7-、CD56-、HLA-DR+和 CD38+患者相比，DFS、OS 和复发率较低。我们的研究结果表明，CD7+、CD56+、HLA-DR-和 CD38-异常表达与不良预后相关，且异常抗原表达数量越多，预后越差。
