Ru Yuhua, Chen Jia, Ferhat Allain-Thibeault, Labussière-Wallet Hélène, Gedde-Dahl Tobias, Kröger Nicolaus, Socié Gérard, Yakoub-Agha Ibrahim, Eder Matthias, Mielke Stephan, Wu Depei, Mohty Mohamad, Ciceri Fabio, Gorin Norbert-Claude
National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou, China.
Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Am J Hematol. 2025 Sep 10. doi: 10.1002/ajh.70069.
Given the dismal prognosis for patients with TP53-mutated acute myeloid leukemia (AML), the optimal donor for those undergoing allogeneic hematopoietic cell transplantation (allo-HCT) remains unclear. We retrospectively analyzed adult patients with TP53-mutated AML who underwent first allo-HCT in CR1 between 2010 and 2021. Outcomes were compared among using a haploidentical donor (Haplo), a matched sibling donor (MSD), and a 10/10 matched unrelated donor (MUD). The analysis comprised 451 patients, including 86 Haplo, 117 MSD, and 248 MUD. Patients in the three groups were transplanted during a similar period. Haplo, MSD, and MUD groups experienced similar incidences of Day 180 Grades II-IV aGVHD (30.9% vs. 23.6% vs. 28.3%), Grades III-IV aGVHD (13.6% vs. 10.1% vs. 9.1%), 2-year cGVHD (28.9.% vs. 30.9% vs. 25.6%) and extensive cGVHD (10.9% vs. 16.1% vs. 13.3%). By multivariate analysis, the outcomes were similar in the three groups. The MSD group was associated with a similar 2-year overall survival (OS: 33.9%; p = 0.799), leukemia-free survival (LFS: 30.5%; p = 0.956), relapse incidence (RI: 54.2%; p = 0.497), non-relapse mortality (NRM: 15.3%; p = 0.368), and GVHD-free, relapse-free survival (GRFS: 21.8%, p = 0.957) when compared with the Haplo group (2-year OS: 46.7%, LFS: 37.4%, RI: 40.8%, NRM: 21.7%, GRFS: 25.7%). The MUD group also experienced a similar 2-year OS (36.9%; p = 0.892), LFS (31%; p = 0.904), RI (50.8%; p = 0.521), NRM (18.2%; p = 0.368) and GRFS (21.9%; p = 0.383) when compared with the Haplo group. In conclusion, outcomes of patients with TP53-mutated AML undergoing allo-HCT from a haploidentical donor were comparable to those from an MSD or 10/10 MUD HCT.
鉴于TP53突变的急性髓系白血病（AML）患者预后不佳，对于接受异基因造血细胞移植（allo-HCT）的患者而言，最佳供体仍不明确。我们回顾性分析了2010年至2021年间在完全缓解期（CR1）接受首次allo-HCT的TP53突变的成年AML患者。比较了单倍体相合供体（Haplo）、同胞全相合供体（MSD）和10/10全相合无关供体（MUD）的移植结果。该分析纳入了451例患者，包括86例Haplo、117例MSD和248例MUD。三组患者在相似的时间段内接受移植。Haplo组、MSD组和MUD组180天II-IV级急性移植物抗宿主病（aGVHD）的发生率相似（分别为30.9%、23.6%和28.3%），III-IV级aGVHD的发生率相似（分别为13.6%、10.1%和9.1%），2年慢性移植物抗宿主病（cGVHD）的发生率相似（分别为28.9%、30.9%和25.6%），广泛性cGVHD的发生率相似（分别为10.9%、16.1%和13.3%）。多因素分析显示，三组的结果相似。与Haplo组相比（2年总生存率[OS]：46.7%，无白血病生存率[LFS]：37.4%，复发率[RI]：40.8%，非复发死亡率[NRM]：21.7%，无移植物抗宿主病和无复发生存率[GRFS]：25.7%），MSD组的2年总生存率（OS：33.9%；p = 0.799）、无白血病生存率（LFS：30.5%；p = 0.956）、复发率（RI：54.2%；p = 0.497）、非复发死亡率（NRM：15.3%；p = 0.368）和无移植物抗宿主病和无复发生存率（GRFS：21.8%，p = 0.957）相似。与Haplo组相比，MUD组的2年总生存率（36.9%；p = 0.892）、无白血病生存率（31%；p = 0.904）、复发率（50.8%；p = 0.521）、非复发死亡率（18.2%；p = 0.368）和无移植物抗宿主病和无复发生存率（21.9%；p = 0.383）也相似。总之，TP53突变的AML患者接受单倍体相合供体allo-HCT的结果与接受MSD或10/10 MUD HCT的结果相当。
