文章：

影响同种异体造血干细胞移植治疗BCR–ABL阳性ALL患者临床预后的预后因素

Prognostic factors influencing clinical outcome of allogeneic hematopoietic stem cell transplantation following imatinib-based therapy in BCR–ABL-positive ALL

原文发布日期：2012-05-18

DOI: 10.1038/bcj.2012.18

类型: Original Article

开放获取: 是

英文摘要：

We investigated prognostic factors for the clinical outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) following imatinib-based therapy. Among 100 adult patients who were prospectively enrolled in the JALSG Ph+ALL202 study, 97 patients obtained complete remission (CR) by imatinib-combined chemotherapy, among whom 60 underwent allo-HSCT in their first CR. The probabilities of overall survival (OS) and disease-free survival (DFS) at 3 years after HSCT were 64% (95% CI, 49–76) and 58% (95% CI, 43–70), respectively. Prognostic factor analysis revealed that the major BCR–ABL transcript was the only unfavorable predictor for OS and DFS after HSCT by both univariate (HR, 3.67 (95% CI 1.49–9.08); P=0.005 and HR, 6.25 (95% CI, 1.88–20.8); P=0.003, respectively) and multivariate analyses (HR, 3.20 (95% CI, 1.21–8.50); P=0.019 and HR, 6.92 (95% CI, 2.09–22.9); P=0.002, respectively). Minimal residual disease status at the time of HSCT had a significant influence on relapse rate (P=0.015). Further study of the BCR–ABL subtype for the clinical impact on outcome of allo-HSCT in Ph+ALL is warranted.

摘要翻译： 

我们研究了基于伊马替尼治疗后，费城染色体阳性急性淋巴细胞白血病（Ph+ALL）患者接受异基因造血干细胞移植（allo-HSCT）临床结局的预后因素。在前瞻性纳入JALSG Ph+ALL202研究的100名成年患者中，97名患者通过伊马替尼联合化疗获得完全缓解（CR），其中60名患者在首次完全缓解期间接受了allo-HSCT。移植后3年总生存率（OS）和无病生存率（DFS）分别为64%（95% CI，49-76）和58%（95% CI，43-70）。预后因素分析显示，主要BCR-ABL转录本是移植后OS和DFS的唯一不利预测因子，这一结论在单变量分析（风险比分别为3.67（95% CI 1.49-9.08），P=0.005和6.25（95% CI 1.88-20.8），P=0.003）和多变量分析（风险比分别为3.20（95% CI 1.21-8.50），P=0.019和6.92（95% CI 2.09-22.9），P=0.002）中均得到验证。移植时微小残留病状态对复发率有显著影响（P=0.015）。有必要进一步研究BCR-ABL亚型对Ph+ALL患者异基因造血干细胞移植结局的临床影响。

原文链接：

Prognostic factors influencing clinical outcome of allogeneic hematopoietic stem cell transplantation following imatinib-based therapy in BCR–ABL-positive ALL