治疗急性淋巴细胞白血病的HCT前的预防性头辐射:促进或不促进
Khalid Halahleh1, Mohammad S Makoseh2, Ayat M Taqash3
1Internal Medicine, Bone Marrow Transplantation and Cellular Therapy Program King Hussein Cancer Center.
Clinical hematology international
|October 17, 2024
概括
在全身辐射中添加头骨辐射增强剂并没有改善过敏淋巴细胞白血病患者接受全原造血细胞移植的结果. 这种方法并没有降低中枢神经系统复发风险或提高生存率.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
背景情况:
- 全身辐射 (TBI) 是在异性造血细胞移植 (allo-HCT) 之前,急性淋巴细胞白血病 (ALL) 患者的标准条件.
- 在所有没有先前中枢神经系统 (CNS) 参与的患者中,除了TBI外,部辐射增强 (CRB) 的作用仍然不清楚.
研究的目的:
- 评估头骨辐射增强 (CRB) 在减少中枢神经系统 (CNS) 复发和改善急性淋巴细胞白血病 (ALL) 患者接受异构造血细胞移植 (allo-HCT) 患者的存活率方面的疗效.
主要方法:
- 对143名没有先前中枢神经系统参与的ALL患者进行了回顾性队列研究,这些患者接受了allo-HCT.
- 患者被分为两组:那些接受TBI与CRB (队列-1) 和那些没有CRB接受TBI (队列-2) 的患者.
- 分析了包括复发率,中枢神经系统复发和生存率在内的结果.
主要成果:
- 没有显著差异的整体复发率 (10%对12%) 或中枢神经系统 (CNS) 复发 (6.6%对0%) 之间的TBI与CRB和TBI没有CRB队列.
- 三年总生存率 (61%) 和无复发生存率 (60%) 在两组之间是相似的.
- 移植时的年龄和表型亚型被确定为中枢神经系统复发的预测因素.
结论:
- 用CRB增加TBI似乎没有改善中枢神经系统复发风险或在没有先前中枢神经系统参与的情况下接受alo-HCT的ALL患者的生存结果.
- 将CRB添加到TBI可能对这个患者群体没有好处.
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