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由于基础疾病接受过先前的化疗,长期移植后的预期寿命可能更短:对连续 9 项 ECOG-ACRIN 试验中招募的 3012 例急性髓系白血病患者进行的分析。

Shorter long-term post-transplant life expectancy may be due to prior chemotherapy for the underlying disease: analysis of 3012 patients with acute myeloid leukemia enrolled on 9 consecutive ECOG-ACRIN trials.

机构信息

Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Department of Hematology, Shaare Zedek Medical Center, Jerusalem, Israel.

出版信息

Bone Marrow Transplant. 2024 Sep;59(9):1215-1223. doi: 10.1038/s41409-024-02308-0. Epub 2024 May 22.

Abstract

Several studies reported that patients with acute myeloid leukemia (AML) who remain in long-term remission after allogeneic or autologous transplant have a shorter life expectancy, compared to the general population. However, little is known about the life expectancy of adult long-term survivors of AML who were treated with chemotherapy alone without a transplant and there have been no comparisons with survival among the general population. The current study indicates that the life expectancy of AML patients who achieved and maintained CR for at least 3 years is shorter than expected for age in the US population. This was observed also in patients who did not undergo a transplant including those who have not relapsed during the entire long follow-up period. Thus, late relapse does not explain why patients without transplants have a shortened life expectancy. Taken together, these data strongly suggest that prior chemotherapy for the underlying AML is at least a major contributing factor for the known shortened life expectancy post-transplant.

摘要

几项研究报告称,与普通人群相比,接受异体或自体移植后长期缓解的急性髓细胞白血病 (AML) 患者的预期寿命更短。然而,对于仅接受化疗而未进行移植且未与普通人群进行生存比较的 AML 成年长期幸存者的预期寿命知之甚少。本研究表明,达到并维持至少 3 年完全缓解 (CR) 的 AML 患者的预期寿命短于美国人群的年龄预期。这在未进行移植的患者中也观察到,包括在整个长期随访期间未复发的患者。因此,晚期复发并不能解释为什么未进行移植的患者预期寿命缩短。综上所述,这些数据强烈表明,先前针对潜在 AML 的化疗至少是移植后已知预期寿命缩短的一个主要因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5320/11368814/41ff8ddbd6fe/41409_2024_2308_Fig1_HTML.jpg

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