机构地区:[1]Peking University People’s Hospital,Peking University Institute of Hematology,National Clinical Research Center for Hematologic Disease,Research Unit of Key Technique for Diagnosis and Treatments of Hematologic Malignancies,Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation,Beijing 100044,China [2]First Affiliated Hospital of Soochow University,Jiangsu Institute of Hematology,Institute of Blood and Marrow Transplantation,Soochow University,Suzhou,Jiangsu 215006,China [3]Nanfang Hospital,Southern Medical University,Guangzhou,Guangdong 510515,China [4]Collaborative Innovation Center of Hematology,Peking University,Beijing 100044,China [5]Peking-Tsinghua Center for Life Sciences,Beijing 100871,China
出 处:《Chinese Medical Journal》2023年第15期1855-1863,共9页中华医学杂志(英文版)
基 金:National Key Research and Development Program of China(No.2019YFC0840606);Ministry of Science and Technology,the National Natural Science Foundation of China(Nos.82070189,81621001 and 82270227);CAMS Innovation Fund for Medical Sciences(CIFMS)(No.2019-I2M-5-034)
摘 要:Background:Although the need for consolidation chemotherapy after successful induction therapy is well established in patients with acute myeloid leukemia(AML)in first complete remission(CR1),the value of consolidation chemotherapy before allogeneic hematopoietic stem cell transplantation remains controversial.Methods:We retrospectively compared the effect of the number of pre-transplant consolidation chemotherapies on outcomes of human leukocyte antigen-matched sibling stem cell transplantation(MSDT)for patients with AML in CR1 in multicenters across China.In our study,we analyzed data of 373 AML patients in CR1 from three centers across China.Results:With a median follow-up of 969 days,patients with≥3 courses of consolidation chemotherapy had higher probabilities of leukemia-free survival(LFS)(85.6%vs.67.0%,P<0.001)and overall survival(89.2%vs.78.5%,P=0.007),and better cumulative incidences of relapse(10.5%vs.19.6%,P=0.020)and non-relapse mortality(4.2%vs.14.9%,P=0.001)than those with≤2 courses of consolidation chemotherapy.Pre-transplantation minimal residual disease-negative patients with AML in CR1 who received MSDT with≥3 courses of consolidation chemotherapy had a higher probability of LFS(85.9%vs.67.7%,P=0.003)and a lower cumulative incidence of relapse(9.6%vs.23.3%,P=0.013)than those with≤2 courses.Conclusion:Our results indicate that patients with AML in CR1 who received MSDT might benefit from pre-transplant consolidation chemotherapy.
关 键 词:Acute myeloid leukemia Allogeneic stem cell transplantation Pre-transplant consolidation chemotherapy HLA-matched sibling stem cell transplantation
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