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异基因干细胞移植在伴有t(8;16)(p11;p13)易位的急性髓系白血病中的作用

The role of allogeneic stem cell transplantation in acute myeloid leukemia with translocation t(8;16)(p11;p13).

作者信息

Schmälter Ann-Kristin, Labopin Myriam, Versluis Jurjen, Gallego Hernanz Maria Pilar, Eder Matthias, von dem Borne Peter, Socié Gerard, Chevallier Patrice, Forcade Edouard, Neubauer Andreas, Baron Frédéric, Bazarbachi Ali, Bug Gesine, Nagler Arnon, Schmid Christoph, Esteve Jordi, Mohty Mohamad, Ciceri Fabio

机构信息

Department of Hematology and Oncology, Augsburg University Hospital and Medical Faculty, Comprehensive Cancer Center Augsburg, Augsburg, Germany.

Bavarian Cancer Research Center (BZKF), Augsburg, Germany.

出版信息

Am J Hematol. 2025 Jan;100(1):85-92. doi: 10.1002/ajh.27496. Epub 2024 Nov 18.

Abstract

Acute myeloid leukemia (AML) with translocation t(8;16)(p11;p13) represents a rare entity that has been categorized as a disease-defining recurring cytogenetic abnormality with adverse risk in the 2022 European LeukemiaNet classification. This rating was mainly based on a retrospective analysis comprising patients from several large clinical trials, which, however, included only 21 patients treated with allogeneic stem cell transplantation (alloSCT). Therefore, the European Society for Blood and Marrow Transplantation performed a registry study on a larger cohort to evaluate the role of alloSCT in t(8;16) AML. Sixty transplant recipients with t(8;16) AML were identified. Two-year overall and leukemia-free survival (OS/LFS) was 43/39%. Patients transplanted in first complete remission (CR1, n = 44) achieved a 2-year OS/LFS of 48%/48%. Following alloSCT in CR1, the multivariable analysis identified a complex karyotype (CK) as a major risk factor for relapse (HR 4.17, p = .016), lower LFS (HR 3.38, p = .01), and lower OS (HR 3.08, p = .017). Two-year OS/LFS of patients with CK was 19%/19%, in contrast to 67%/67% in patients with t(8;16) outside a CK. Other factors for inferior outcomes were older age and secondary AML. In summary, alloSCT could mitigate the adverse risk of patients with t(8;16) AML not harboring a CK, particularly when performed in CR1.

摘要

伴有t(8;16)(p11;p13)易位的急性髓系白血病(AML)是一种罕见的疾病实体,在2022年欧洲白血病网分类中被归类为具有不良风险的疾病定义性复发性细胞遗传学异常。这一评级主要基于一项回顾性分析,该分析纳入了来自多个大型临床试验的患者,但其中仅21例接受了异基因干细胞移植(alloSCT)。因此,欧洲血液和骨髓移植学会对更大的队列进行了一项登记研究,以评估alloSCT在t(8;16) AML中的作用。共确定了60例t(8;16) AML移植受者。两年总生存率和无白血病生存率(OS/LFS)分别为43%/39%。首次完全缓解期(CR1,n = 44)接受移植的患者两年OS/LFS为48%/48%。在CR1期接受alloSCT后,多变量分析确定复杂核型(CK)是复发的主要危险因素(HR 4.17,p = 0.016),较低的LFS(HR 3.38,p = 0.01)和较低的OS(HR 3.08,p = 0.017)。CK患者的两年OS/LFS为19%/19%,而CK以外t(8;16)患者为67%/67%。其他预后较差的因素包括年龄较大和继发性AML。总之,alloSCT可以减轻不伴有CK的t(8;16) AML患者的不良风险,特别是在CR1期进行移植时。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df86/11625973/9b005120ece4/AJH-100-85-g002.jpg

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