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中国异基因造血干细胞移植后白血病复发监测、治疗与预防的专家共识:2024 年更新版。

Consensus on the monitoring, treatment, and prevention of leukaemia relapse after allogeneic haematopoietic stem cell transplantation in China: 2024 update.

机构信息

Peking University People's Hospital & Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, PR China.

Shanghai Children's Medical Center, Shanghai, PR China.

出版信息

Cancer Lett. 2024 Nov 28;605:217264. doi: 10.1016/j.canlet.2024.217264. Epub 2024 Sep 25.

DOI:10.1016/j.canlet.2024.217264
PMID:39332587
Abstract

The consensus in 2018 from The Chinese Society of Haematology (CSH) on the monitoring, treatment, and prevention of leukaemia relapse after allogeneic haematopoietic stem cell transplantation (HSCT) facilitated the standardization of clinical practices in China and progressive integration with the world. To integrate recent developments and further improve the consensus, a panel of experts from the CSH recently updated the following consensus: (1) integrate risk-adapted, measurable residual disease (MRD)-guided strategy on modified donor lymphocyte infusion (DLI) and interferon-α into total therapy, which was pioneered and refined by Chinese researchers; (2) provide additional evidence of the superiority of haploidentical HSCT (the dominant donor source in China) to matched HSCT for high-risk populations, especially for pre-HSCT MRD-positive patients; (3) support the rapid progress of techniques for MRD detection, such as next-generation sequencing (NGS) and leukaemia stem cell-based MRD detection; and (4) address the role of new targeted options in transplant settings. In conclusion, the establishment of a "total therapy" strategy represents a great step forward. We hope that the consensus updated by Chinese scholars will include the latest cutting-edge developments and inspire progress in post-HSCT relapse management.

摘要

2018 年,中华血液学分会(CSH)就异基因造血干细胞移植(HSCT)后白血病复发的监测、治疗和预防达成共识,促进了中国临床实践的规范化和与世界的逐步融合。为了整合最新进展并进一步完善共识,CSH 的专家组最近更新了以下共识:(1)将风险适应、基于微小残留病(MRD)的改良供者淋巴细胞输注(DLI)和干扰素-α策略纳入由中国研究者首创和完善的总治疗中;(2)为高危人群(尤其是 HSCT 前 MRD 阳性患者)提供来自半相合供体 HSCT 优于匹配 HSCT 的额外证据;(3)支持 MRD 检测技术(如下一代测序(NGS)和基于白血病干细胞的 MRD 检测)的快速发展;(4)解决移植环境中新靶向选择的作用。总之,建立“总治疗”策略是向前迈出的一大步。我们希望中国学者更新的共识将纳入最新的前沿进展,并激发 HSCT 后复发管理的进展。

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