文章：

早期移植后因素可预测接受异基因造血干细胞移植的骨髓纤维化患者的生存结局

Early post-transplantation factors predict survival outcomes in patients undergoing allogeneic hematopoietic cell transplantation for myelofibrosis

原文发布日期：2020-03-10

DOI: 10.1038/s41408-020-0302-9

类型: Article

开放获取: 是

英文摘要：

Factors predicting allogeneic hematopoietic cell transplantation (HCT) outcomes in myelofibrosis in the early post-HCT period have not been defined thus far. We attempt to study such factors that can help identify patients at a higher risk of relapse or death. This retrospective study included 79 patients who underwent first HCT for myelofibrosis at three centers between 2005 and 2016. Univariate analysis showed that red blood cell (RBC) transfusion dependence (HR 9.02, 95% CI 4.0–20.35), platelet transfusion dependence (HR 8.17, 95%CI 3.83–17.37), 100% donor chimerism in CD33 + cells (HR 0.21, 95%CI 0.07–0.62), unfavorable molecular status (HR 4.41, 95%CI 1.87–10.39), normal spleen size (HR 0.42, 95%CI 0.19–0.94), grade ≥ 2 bone marrow fibrosis (vs. grade ≤ 1; HR 2.7, 95%CI 1.1–6.93) and poor graft function (HR 2.6, 95%CI 1.22–5.53) at day +100 were statistically significantly associated with relapse-free survival (RFS). RBC transfusion dependence and unfavorable molecular status were also statistically significant in the multivariate analysis. Patients in whom both of these factors were present had a significantly worse RFS when compared to those with one or none. While limited by a small sample size, we demonstrate the significance of transfusion dependence and molecular status at day +100 in predicting outcomes.
 

摘要翻译： 

预测骨髓纤维化患者异基因造血细胞移植（HCT）后早期结局的因素迄今尚未明确。本研究试图探讨有助于识别复发或死亡高风险患者的此类因素。这项回顾性研究纳入了2005年至2016年间在三个中心首次因骨髓纤维化接受HCT的79例患者。单因素分析显示：红细胞输注依赖（HR 9.02, 95%CI 4.0–20.35）、血小板输注依赖（HR 8.17, 95%CI 3.83–17.37）、CD33+细胞100%供体嵌合（HR 0.21, 95%CI 0.07–0.62）、不利分子状态（HR 4.41, 95%CI 1.87–10.39）、正常脾脏大小（HR 0.42, 95%CI 0.19–0.94）、≥2级骨髓纤维化（对比≤1级；HR 2.7, 95%CI 1.1–6.93）以及移植后第100天不良移植物功能（HR 2.6, 95%CI 1.22–5.53）与无复发生存期（RFS）存在统计学显著关联。多因素分析中红细胞输注依赖和不利分子状态同样具有统计学显著性。同时存在这两个因素的患者，其RFS显著差于仅存在一个或不存在任何因素的患者。尽管受限于小样本量，我们证实了移植后第100天输注依赖状态和分子状态对预后评估的重要意义。

原文链接：

Early post-transplantation factors predict survival outcomes in patients undergoing allogeneic hematopoietic cell transplantation for myelofibrosis