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首页> 外文期刊>Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation >Significance of Persistent Cytogenetic Abnormalities on Myeloablative Allogeneic Stem Cell Transplantation in First Complete Remission
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Significance of Persistent Cytogenetic Abnormalities on Myeloablative Allogeneic Stem Cell Transplantation in First Complete Remission

机译：永久性细胞遗传异常对首次完全缓解的清髓同种异体干细胞移植的意义

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Risk stratification is important to identify patients with acute myelogenous leukemia (AML) who might benefit from allogeneic hematopoietic stem cell transplantation (allo-HSCT) in first complete remission. We retrospectively studied 150 patients with AML and diagnostic cytogenetic abnormalities who underwent myeloablative allo-HSCT while in first complete remission to evaluate the prognostic impact of persistent cytogenetic abnormalities at allo-HSCT. Three risk groups were identified. Patients with favorable/intermediate cytogenetics at diagnosis (n = 49) and patients with unfavorable cytogenetics at diagnosis but without a persistent abnormal clone at allo-HSCT (n = 83) had a similar 3-year leukemia-free survival of 58%-60% despite the higher 3-year relapse incidence (RI) in the latter group (32.3%, versus 16.8% in the former group). A third group of patients with unfavorable cytogenetics at diagnosis and a persistent abnormal clone at allo-HSCT (n = 15) had the worst prognosis, with a 3-year RI of 57.5% and 3-year leukemia-free survival of only 29.2%. These data suggest that patients with AML and unfavorable cytogenetics at diagnosis and a persistent abnormal clone at allo-HSCT are at high risk for relapse after allo-HSCT. These patients should be considered for clinical trials designed to optimize conditioning regimens and/or to use preemptive strategies in the posttransplantion setting aimed at decreasing RI.
机译：风险分层对于识别急性骨髓性白血病（AML）的患者至关重要，这些患者在首次完全缓解后可能会受益于同种异体造血干细胞移植（allo-HSCT）。我们回顾性研究了150名患有AML和细胞遗传学诊断异常的患者，他们在首次完全缓解时接受了清髓的allo-HSCT，以评估持续的细胞遗传学异常对allo-HSCT的预后影响。确定了三个风险组。在诊断时具有良好/中级细胞遗传学的患者（n = 49）和在诊断时具有良好细胞遗传学的患者但在allo-HSCT中没有持续异常克隆的患者（n = 83）具有相似的3年无白血病生存率，为58％-60尽管后一组的3年复发率（RI）较高，但仍为％（32.3％，前一组为16.8％）。第三组在诊断时细胞遗传学不良且在allo-HSCT上存在持续异常克隆的患者（n = 15）预后最差，3年RI为57.5％，3年无白血病生存率仅为29.2％ 。这些数据表明，患有AML和细胞遗传学不良且在allo-HSCT处持续存在异常克隆的患者在allo-HSCT后复发的高风险。这些患者应考虑进行临床试验，旨在优化条件治疗方案和/或在旨在降低RI的移植后环境中采用抢先策略。

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