文章：

同种异基因造血干细胞移植治疗急性髓系白血病：一项倾向评分匹配分析

Syngeneic hematopoietic stem cell transplantation for acute myeloid leukemia: a propensity score-matched analysis

原文发布日期：2021-09-24

DOI: 10.1038/s41408-021-00553-w

类型: Article

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英文摘要：

The present study evaluated outcomes and prognostic factors in adult patients with acute myeloid leukemia (AML) after syngeneic hematopoietic stem cell transplantation (HSCT). Among patients in first complete remission (CR1), outcomes of syngeneic HSCT (Syn) were compared with those of autologous HSCT (Auto), allogeneic HSCT from human leukocyte antigen (HLA)-matched sibling donor (MSD), or allogeneic HSCT from HLA-matched unrelated donor (MUD). Among 11,866 patients receiving first HSCT, 26 in the Syn group were analyzed. The 5-year overall survival (OS) rate, the cumulative incidence of relapse, and the cumulative incidence of non-relapse mortality (NRM) were 47.8%, 59.6%, and 4.6%, respectively. The OS was significantly better in patients in CR1 (n = 13) than in patients in non-CR1 (P = 0.012). Furthermore, 39 patients in CR1 each were assigned to the Auto, MSD, and MUD groups using propensity score matching. The 5-year OS in the Syn (68.4%) was not significantly different from those in the Auto (55.9%, P = 0.265), MSD (62.4%, P = 0.419), or MUD (63.7%, P = 0.409) groups. A higher relapse in the Syn than in the MSD and MUD groups was offset by lower NRM. In summary, syngeneic HSCT might be an alternative option for AML patients in CR1.
 

摘要翻译： 

本研究评估了成人急性髓系白血病（AML）患者接受同基因造血干细胞移植（HSCT）后的疗效及预后因素。针对首次完全缓解（CR1）的患者，将同基因HSCT（Syn）的疗效与自体HSCT（Auto）、人类白细胞抗原（HLA）匹配同胞供者（MSD）异基因HSCT及HLA匹配无关供者（MUD）异基因HSCT进行对比。在11,866例接受首次HSCT的患者中，共纳入Syn组26例进行分析。其5年总生存（OS）率、累积复发率和非复发死亡率（NRM）分别为47.8%、59.6%和4.6%。CR1患者（13例）的OS显著优于非CR1患者（P=0.012）。进一步采用倾向评分匹配法，将CR1患者各39例分配至Auto、MSD和MUD组。Syn组的5年OS率（68.4%）与Auto组（55.9%，P=0.265）、MSD组（62.4%，P=0.419）及MUD组（63.7%，P=0.409）均无显著差异。Syn组较高的复发率被较低的NRM所抵消，其疗效与MSD及MUD组相当。综上所述，同基因HSCT或可作为CR1期AML患者的备选治疗方案。

原文链接：

Syngeneic hematopoietic stem cell transplantation for acute myeloid leukemia: a propensity score-matched analysis