异构性造血细胞移植用于形血细胞状树突细胞瘤:CIBMTR分析
Hemant S Murthy1, Mei-Jie Zhang2,3, Karen Chen3
1Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL.
Blood advances
|October 4, 2023
概括
全基性造血细胞移植 (allo-HCT) 提供了可持续的缓解和长期存活的可塑性血细胞状树突细胞瘤 (BPDCN). 年龄较小,CR1状况较低,与全身辐射 (MAC-TBI) 相关的骨髓损伤条件改善了结果.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 移植医学 移植医学
背景情况:
- 囊性血细胞状树突细胞瘤 (BPDCN) 是一种罕见的,侵袭性的血液性恶性瘤.
- 传统化疗对BPDCN患者的疗效有限,预后不佳.
- 在小型研究中,异构造血细胞移植 (allo-HCT) 已经显示出持久缓解的潜力.
研究的目的:
- 在一大群BPDCN患者中分析alo-HCT的疗效和结果.
- 确定影响BPDCN.allo-HCT后生存和复发的预后因素.
- 评估调节方案对BPDCN患者移植后结果的影响.
主要方法:
- 在2007-2018年间接受了allo-HCT的164名BPDCN患者的回顾性分析.
- 从国际血液和骨髓移植研究中心 (CIBMTR) 登记处收集的数据.
- 进行了多变量分析,以确定总生存 (OS),无病生存 (DFS),复发和非复发死亡率 (NRM) 的预测因素.
主要成果:
- 五年后的OS和DFS率分别为51.2%和44.4%.
- 疾病复发是死亡的主要原因 (32.2%的复发率).
- 年龄较大 (≥60岁),移植时的非最佳缓解状态和较高的NRM (23.3%) 与较差的结局有关.
- 用全身辐射 (MAC-TBI) 进行骨髓缩条件预测了改善DFS和降低复发风险.
结论:
- -HCT是一种有效的治疗BPDCN,提供持久的缓解和长期存活.
- 年龄较小,在移植前达到CR1和MAC-TBI是有利的预后因素.
- 进一步的研究和结合alo-HCT的新策略对于提高BPDCN治疗结果至关重要.
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