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移植在所有:谁,什么时候,以及如何?

Curtis Marcoux¹, Partow Kebriaei²

¹Division of Hematology, Dalhousie University, Halifax, Canada.

Hematology. American Society of Hematology. Education Program

|December 7, 2024

概括

同源干细胞移植 (allo-HCT) 是高风险急性淋巴细胞白血病 (ALL) 的关键. 分子分析和可测量的残留疾病 (MRD) 评估方面的进展完善了对alo-HCT的患者选择.

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:

全源性造血干细胞移植 (allo-HCT) 是高风险急性淋巴细胞白血病 (ALL) 的关键治疗方法.
由于不断发展的治疗策略,针对alo-HCT的最佳患者选择是复杂的.
精细的风险分层对于平衡移植效益与毒性至关重要.

研究的目的:

审查当前alo-HCT在成人ALL治疗中的作用.
讨论第一次缓解时使用alo-HCT的适应症.
探索新型疗法的整合以及在供体选择和调节方面的进展.

主要方法:

关于成人ALL的allo-HCT的当代文献的综述.
分析分子表征和可测量的残留疾病 (MRD) 对移植决策的影响.
扩大供体选择和新型免疫疗法/向治疗的评估.

主要成果:

可测量的残留疾病 (MRD) 是复发的强有力的预测因素,影响了MRD阴性患者的移植需要.
顺序相同的移植和降低强度的调节扩大了 allo-HCT 的适用性.
免疫疗法和向药物的整合有助于在晚期疾病中成功移植.

结论:

适用于成人ALL的当代alo-HCT策略需要根据分子风险和MRD状态仔细选择患者.
供体选择和调节方案的进步提高了移植结果.
移植与新疗法的最佳顺序对于最大限度地提高ALL治疗的疗效至关重要.

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