预先条件的脆弱现象型影响了老年异构移植接受者的生存和复发
Anthony D Sung1, Thuy Koll2, Shannon H Gier3
1Department of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina.
Transplantation and cellular therapy
|January 19, 2024
概括
在血造细胞移植 (HCT) 之前,Fried的脆弱性表型 (FFP) 评估显著影响了老年人的生存率. 在HCT前的脆弱性状态对于预测结果和指导治疗决策在这个人群中至关重要.
科学领域:
- 老年医学 老年医学
- 血液学 血液学 血液学
- 在瘤学瘤学.
背景情况:
- 血液性恶性瘤不成比例地影响着老年人.
- 血造细胞移植 (HCT) 具有治愈潜力,但由于老年患者的生存率较低而受到限制.
- 弗里德的脆弱性表型 (FFP) 是一个经过验证的老年患者评估工具.
研究的目的:
- 评估HCT前FFP与老年人HCT后结局的相关性.
- 在60岁及以上的患者中确定影响HCT后生存和复发的因素.
主要方法:
- 在280名年龄≥60岁的HCT接受者中进行了FFP评估,这些接受者在条件化之前患有急性白血病或髓状瘤.
- 包括整体存活率 (OS),非复发死亡率 (NRM) 和复发在内的结果与FFP,年龄和其他临床因素相关分析.
- 统计分析包括限制平均生存时间 (RMST) 和复发时间 (RMRT) 的单变量和多变量建模.
主要成果:
- 与60-69岁患者相比,70岁以上的患者的生存状况较差,NRM较高.
- 虚弱状态 (适合,前虚弱,虚弱) 显著影响了2年的生存期,适合患者的生存率更好.
- 虚弱前和虚弱的患者有较高的疾病相关死亡率,FFP是复发的重要预测因素.
结论:
- 在老年人中,年龄和FFP都是HCT后生存的关键决定因素.
- 将FFP纳入HCT前评估可以提高风险分层和患者咨询.
- 未来的研究应该探索减轻脆弱性的干预措施和新的HCT策略,以改善结果.
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