Haploidentical 干细胞供者选择用于急性髓系白血病患者:来自 EBMT 的 ALWP 的研究。

Haploidentical stem cell donor choice for patients with acute myeloid leukemia: a study from the ALWP of the EBMT.

机构信息

Hematology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.

CIBERONC, Carlos III Health Institute, Madrid, Spain.

出版信息

Blood Adv. 2024 May 28;8(10):2332-2341. doi: 10.1182/bloodadvances.2023012133.

Abstract

There is a paucity of information to guide the selection of the most suitable donor in haploidentical (Haplo) hematopoietic stem cell transplantation (HSCT). For this reason, from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation, we conducted a retrospective analysis to evaluate the impact of Haplo donor characteristics on outcomes in patients with acute myeloid leukemia (AML) who received graft-versus-host disease prophylaxis with posttransplant cyclophosphamide (PTCy). The primary end point was graft-versus-host disease (GVHD)-free and relapse-free survival (GRFS). Overall, 2200 patients were included. The median age of donors was 37 years (range, 8-71); 820 (37%) were females, including 458 (21%) who were used for male recipients. In addition, 1631 donors (74%) donated peripheral blood (PB). Multivariable analysis identified certain donor-related risk factors with a detrimental impact on transplant outcomes. The use of PB, older donors' ages (>37 years), and female donors to male recipients negatively affected GRFS. Donor's age and female donor-to-male recipient combination also affected nonrelapse mortality, leukemia-free survival, and overall survival. In conclusion, donor-related variables significantly influence outcomes in patients with AML after Haplo-HSCT with PTCy. When possible, younger donors and male donors for male recipients should be prioritized. The use of bone marrow can additionally prevent GVHD.

摘要

关于如何选择最合适的单倍体(Haplo)造血干细胞供者,目前信息有限。出于这个原因,来自欧洲血液和骨髓移植学会急性白血病工作组的我们进行了一项回顾性分析,以评估在接受环磷酰胺(PTCy)预防移植物抗宿主病(GVHD)的急性髓细胞白血病(AML)患者中,Haplo 供者特征对结局的影响。主要终点是无 GVHD 和无复发存活率(GRFS)。总体上纳入了 2200 名患者。供者的中位年龄为 37 岁(范围,8-71);820 名(37%)为女性,包括 458 名(21%)用于男性受者。此外,1631 名供者(74%)捐献了外周血(PB)。多变量分析确定了某些与供者相关的风险因素,这些因素对移植结局有不利影响。使用 PB、年龄较大的供者(>37 岁)和女性供者给男性受者会对 GRFS 产生负面影响。供者的年龄和女性供者给男性受者的组合也会影响无复发死亡率、无白血病存活率和总生存率。总之,在接受 PTCy 的 Haplo-HSCT 后,与供者相关的变量会显著影响 AML 患者的结局。在可能的情况下,应优先选择年轻的供者和男性供者给男性受者。使用骨髓还可以预防 GVHD。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a858/11127221/53476995bb69/BLOODA_ADV-2023-012133-ga1.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索