Aichi Cancer Center, Nagoya, Japan.
Sapporo Hokuyu Hospital, Sapporo, Japan.
Bone Marrow Transplant. 2022 Jan;57(1):78-82. doi: 10.1038/s41409-021-01501-9. Epub 2021 Oct 13.
Autologous hematopoietic cell transplantation (HCT) is an effective therapy for patients with relapsed acute promyelocytic leukemia (APL). However, it remains unclear whether this procedure is equally effective for certain groups of patients. To address this question, we analyzed 296 patients with APL who had undergone autologous HCT during second or subsequent complete remission (CR2+) between 2006 and 2019. Among them, 24 patients were ≥65 years old, and 17 underwent autologous HCT during third or subsequent CR. Of the 286 patients whose measurable residual disease (MRD) data were available, 21 showed detectable MRD. The 5-year probabilities of relapse-free survival (RFS), overall survival, relapse, and nonrelapse mortality for the entire cohort were 85%, 88%, 9%, and 6%, respectively. The multivariate analysis revealed that the duration of first CR ( < or ≥2 years) was the sole factor associated with RFS (P = 0.002), but even those with CR1 duration <2 years showed a 5-year RFS of 76%. The other factors such as age, disease status, and MRD status were not predictive for the survival outcomes. Our findings demonstrate very favorable long-term results when autologous HCT is conducted during CR2 + across the various subgroups of patients with relapsed APL.
自体造血细胞移植（HCT）是治疗复发性急性早幼粒细胞白血病（APL）患者的有效方法。然而，对于某些特定群体的患者，该程序是否同样有效仍不清楚。为了解决这个问题，我们分析了 2006 年至 2019 年间接受第二次或随后完全缓解（CR2+）期间的自体 HCT 的 296 例 APL 患者。其中，24 例患者年龄≥65 岁，17 例患者在第三次或随后的 CR 期间进行了自体 HCT。在可获得可测量残留疾病（MRD）数据的 286 例患者中，有 21 例显示可检测到的 MRD。整个队列的 5 年无复发生存率（RFS）、总生存率、复发率和非复发死亡率分别为 85%、88%、9%和 6%。多因素分析显示，首次 CR 持续时间（<2 年或≥2 年）是与 RFS 相关的唯一因素（P=0.002），但即使 CR1 持续时间<2 年的患者也有 5 年的 RFS 为 76%。其他因素，如年龄、疾病状态和 MRD 状态，对生存结果没有预测作用。我们的研究结果表明，在复发性 APL 患者的各个亚组中，在 CR2+期间进行自体 HCT 可获得非常有利的长期结果。
