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首页> 外文期刊>Leukemia >Risk assessment in adult acute lymphoblastic leukaemia before early haemopoietic stem cell transplantation with a geno-identical donor: an easy clinical prognostic score to identify patients who benefit most from allogeneic haemopoietic stem cell transplantation
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Risk assessment in adult acute lymphoblastic leukaemia before early haemopoietic stem cell transplantation with a geno-identical donor: an easy clinical prognostic score to identify patients who benefit most from allogeneic haemopoietic stem cell transplantation

机译：使用基因相同的供体在早期造血干细胞移植前进行成人急性淋巴细胞白血病的风险评估：一项简单的临床预后评分，可确定受益于同种异体造血干细胞移植的患者

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In 1402 patients allografted in Europe during the period 1990–2000 with an HLA-identical sibling in first remission (CR1), the median interval from CR1 to allotransplant (96 days) was a major prognostic factor, patients transplanted earlier having a worse outcome. We studied in depth the 414 fully evaluable patients transplanted less than 96 days after achieving CR1; in these patients, only three factors predicted for the outcome by multivariate analysis: patient age, CR1 achievement with one or more induction courses and the recipient/donor sex combination. These three factors overcame the information from cytogenetics and source of stem cells. Three prognostic groups could be identified in relation to the outcome, using a prognostic score affecting 1 to each poor risk factor (total from 0 to 3): Group 1 (good prognosis) includes patients <35 years old, achieving CR1 with one induction course and to be transplanted with any other sex combination than female to male (score 0); group 2 (intermediate) with one adverse factor (score 1); and group 3 (bad prognosis) with two or three adverse criteria (scores 2 and 3). In these three groups, the 3-year leukaemia-free survival was 565%, 484% and 294% and the overall survival was 655, 534 and 295%, respectively. Therefore, adult patients with ALL and a score of 0 or 1 are good candidates for an early transplant if they have an identical sibling donor. Patient age, response to induction and the sex of the HLA-identical family donor (if existing) are the strongest easy predictors of the outcome for an early transplant in an adult patient with ALL. No additional information is mandatory.
机译：在1990年至2000年期间，欧洲有1402例同种异体移植患者，其初次缓解的HLA同胞（CR1）中，从CR1到同种异体移植的平均间隔（96天）是主要的预后因素，早期移植的患者预后较差。我们对414例完全可评估的患者在获得CR1后不到96天的时间内进行了深入研究。在这些患者中，通过多因素分析只能预测三个因素：患者年龄，一个或多个诱导疗程的CR1成就以及接受者/供者性别组合。这三个因素克服了来自细胞遗传学和干细胞来源的信息。可以根据预后评分将三个预后组与结果相关联，对每个不良危险因素（总分从0到3）使用1个预后评分：第1组（预后良好）包括<35岁的患者，通过一个诱导疗程达到CR1并以除性别以外的任何其他性别组合进行移植（得分0）;第2组（中级）有一个不利因素（得分1）;第3组（预后不良）有两个或三个不利标准（得分2和3）。在这三组中，3年无白血病生存率分别为565％，484％和294％，总生存率分别为655％，534％和295％。因此，ALL评分为0或1的成年患者，如果其同胞供体相同，则是早期移植的良好候选者。患者的年龄，对诱导的反应以及与HLA相同的家庭供体（如果存在）的性别，是成年ALL患者早期移植结局的最容易预测指标。不需要其他信息。

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