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7例BCR::ABL1融合的急性髓系白血病异基因造血干细胞移植的临床分析

[Clinical analysis of allogeneic hematopoietic stem cell transplantation for seven cases of acute myeloid leukemia with BCR::ABL1 fusion].

作者信息

Hao M Z, Zhao X L, Zhang X Y, Shi Y Y, Gong M, Zhang L N, Chen S L, Wei J L, He Y, Feng S Z, Han M Z, Jiang E L

机构信息

State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2023 Dec 14;44(12):995-1000. doi: 10.3760/cma.j.issn.0253-2727.2023.12.005.

Abstract

To explore the efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in acute myeloid leukemia (AML) patients with BCR::ABL1 fusion. The clinical data of seven AML patients with BCR::ABL1 fusion from November 2012 to January 2022 were retrospectively analyzed, and their survival status was followed up. The median age of patients at the time of diagnosis was 35 years. Four cases (57.1%) were diagnosed with high leukocyte counts. All cases were assayed as BCR::ABL1 positive and accompanied by four types of gene mutations (NPM1, RUNX1, ASXL1, PHF6) . Seven patients received tyrosine kinase inhibitor (TKI) combined with induction chemotherapy and bridged to allo-HSCT, and six patients received maintenance therapy with TKI. Before allo-HSCT, six patients achieved complete remission, and four patients achieved complete molecular remission (CMR) . After allo-HSCT, the three remaining cases also achieved CMR. All patients were in remission post-allo-HSCT. One case died of infection, and the remaining cases survived without relapse. The 3-year cumulative overall survival rate was (80.0±17.9) %. TKI combined with traditional chemotherapy could achieve a high response rate in AML patients with BCR::ABL1 fusion. In addition, allo-HSCT could enhance the molecular response rate. Maintenance therapy post-HSCT with TKI could improve prognosis.

摘要

探讨异基因造血干细胞移植(allo-HSCT)治疗伴有BCR::ABL1融合的急性髓系白血病(AML)患者的疗效。回顾性分析2012年11月至2022年1月7例伴有BCR::ABL1融合的AML患者的临床资料,并对其生存状况进行随访。患者诊断时的中位年龄为35岁。4例(57.1%)诊断时白细胞计数高。所有病例检测均为BCR::ABL1阳性,并伴有四种基因突变(NPM1、RUNX1、ASXL1、PHF6)。7例患者接受酪氨酸激酶抑制剂(TKI)联合诱导化疗并过渡到allo-HSCT,6例患者接受TKI维持治疗。allo-HSCT前,6例患者达到完全缓解,4例患者达到完全分子缓解(CMR)。allo-HSCT后,其余3例也达到CMR。所有患者allo-HSCT后均处于缓解状态。1例死于感染,其余病例存活且无复发。3年累积总生存率为(80.0±17.9)%。TKI联合传统化疗在伴有BCR::ABL1融合的AML患者中可获得较高的缓解率。此外,allo-HSCT可提高分子缓解率。HSCT后使用TKI维持治疗可改善预后。

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