Optimized therapeutic strategy for patients with refractory or relapsed acutemyeloid leukemia:long-term clinical outcomes and health-related quality of life assessment  

作　　者：Chen-hua Yan Yu Wang Yu-qian Sun Yi-fei Cheng Xiao-dong Mo Feng-rong Wang Yu-hong Chen Yuan-yuan Zhang Ting-ting Han Huan Chen Lan-ping Xu Xiao-hui Zhang Kai-yan Liu Xiao-jun Huang 

机构地区：[1]Peking University Peoples Hospital,Peking University Institute of Hematology,Beijing 100044,P.R.China [2]National Clinical Research Center for Hematologic Disease,Beijing 100044,P.R.China [3]Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation,Beijing 100044,P.R.China [4]Peking-Tsinghua Center for Life Science,Beijing 100044,P.R.China

出　　处：《Cancer Communications》2022年第12期1387-1402,共16页癌症通讯（英文）

基　　金：Innovative Research Groups of the National Natural Science Foundation of China,Grant/Award Number:81621001;National Key Research and Development Program of China,Grant/Award Number:2017YFA0104500;National Natural Science Foundation of China,Grant/Award Number:81930004。

摘　　要：Background:Patients with refractory or relapsed acute myeloid leukemia(AML)have poor survival,necessitating the exploration of optimized therapeutic strategy.Here,we aimed to investigate clinical outcomes and health-related quality of life(HR-QoL)after total therapy,which included allogeneic hematopoietic stem cell transplantation(allo-HSCT),and prophylactic donor lymphocyte infusion(DLI)in the early phase after transplantation,followed bymultiplemeasurable residual disease(MRD)and graft-versus-host disease(GvHD)-guided DLIs.Methods:Consecutive patients who had refractory or relapsed AML and had received non-T-cell-depleted allo-HSCT at Peking University Institute of Hematology were included in the study.If the patients achieved complete remission at 30 days after transplantation and had no evidence of relapse,severe infection,organ failure,and active GvHD at the time of planned DLI,prophylactic DLI was administered at 30 days after transplantation for human leukocyte antigen(HLA)-matched related HSCT or at 45-60 days after transplantation for haploidentical or unrelated HSCT.Subsequently,multiple DLIs were administered based on MRD results and whether they developed GvHD after transplantation.Results:A total of 105 patients were eligible.Eighty-seven patients received prophylactic DLI(group B),while 18 did not receive prophylactic DLI(group A).Among 105 patients,the cumulative incidence of grade 2-4 acute GvHD and chronic GvHDwas 40.6%(95%confidence interval[CI]=30.6%-50.6%)and 73.3%(95%CI=67.4%-79.2%),respectively.The cumulative incidence of relapse(CIR),transplant-related mortality(TRM),and leukemia-free survival(LFS)at 5 years after transplantation were 31.5%(95%CI=21.9%-41.1%),22.1%(95%CI=11.3%-32.9%),and 46.4%(95%CI=36.8%-56.0%),respectively.In group B,the CIR,TRM,and LFS at 5 years after transplantation were 27.6%(95%CI=17.6%-37.6%),21.6%(95%CI=11.2%-32.0%),and 50.8%(95%CI=40.0%-61.6%),respectively.At the end of follow-up,48 patients survived,and more than 90%of survivors had satisfactory recoveries of HR-

关 键 词：acute myeloid leukemia allogeneic hematopoietic stem cell transplantation REFRACTORY RELAPSED total therapy 

分 类 号：R733.7[医药卫生—肿瘤]