在70岁以上的患有活性AML的患者中,使用异构HCT进行序列治疗:单中心回顾性分析
Odelia Amit1, Gil Fridberg1, Yakir Moshe1
1Bone Marrow Transplantation Unit, Aviv Sourasky Medical Center and Gray School of Medical Sciences, Aviv University.
Haematologica
|January 22, 2026
概括
患有复发性/耐药性急性髓性白血病 (AML) 的老年患者可以接受顺序治疗和全基造血细胞移植 (HCT). 这种方法显示出有希望的生存率和可管理的GVHD,为老年AML患者提供了希望.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 移植免疫学 移植免疫学
背景情况:
- 老年人 (≥70岁) 患有复发性或耐药性急性髓性白血病 (AML) 的预后非常差.
- 传统的治疗方法在这个脆弱的患者群体中具有有限的疗效.
研究的目的:
- 评估一项旨在在老年患有活性复发性/耐药性AML的老年患者中直接全源性造血细胞移植 (HCT) 的顺序治疗方法的疗效和安全性.
- 为了确定与这一队列中死亡率相关的因素.
主要方法:
- 对51名年龄在70岁以上的连续患者进行了回顾性分析,这些患者患有初级耐药性/复发性AML,并通过FITCy序列治疗方案进行了HCT.
- 评估移植与宿主疾病 (GVHD),非复发性死亡率 (NRM),完全缓解率 (CR),复发发病率 (RI) 和整体存活率 (OS).
主要成果:
- 在3年内,总生存率 (OS) 为31%,无GVHD,无复发生存率 (GRFS) 为30%,NRM为36%.
- 82.4%的患者在HCT后的第30天实现了CR,三年RI为27.8%.
- 多变量分析发现较差的ELN-2022分数,复发的AML,没有ATG,以及较低的预先条件化白蛋白作为较高死亡率的预测因素.
结论:
- 顺序疗法随后的全源性HCT是老年患者复发/耐药AML的可行策略,实现高CR率和可接受的生存结果.
- 开发了OS的预测模型,将患者分为低风险,中风险和高风险组,具有不同的生存预期.
- 需要进一步的研究来优化这种方法,并改善这一具有挑战性的患者群体的治疗结果.
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