医学
造血细胞
髓系白血病
内科学
移植
供者淋巴细胞输注
造血
造血干细胞移植
白血病
肿瘤科
入射(几何)
外科
干细胞
生物
光学
物理
遗传学
作者
Masamitsu Yanada,Takaaki Konuma,Satoshi Yamasaki,Tadakazu Kondo,Takahiro Fukuda,Naoki Shingai,Masashi Sawa,Yukiyasu Ozawa,Masatsugu Tanaka,Naoyuki Uchida,Hirohisa Nakamae,Yuta Katayama,Ken Matsuoka,Takafumi Kimura,Yoshinobu Kanda,Tatsuo Ichinohe,Yoshiko Atsuta,Shingo Yano
标识
DOI:10.1038/s41409-020-01163-z
摘要
Posttransplant relapse represents the greatest obstacle to the success of allogeneic hematopoietic cell transplantation (HCT) for patients with acute myeloid leukemia (AML). This study investigated clinical features and outcomes of posttransplant relapse of AML based on data for 1265 patients with AML suffering relapse after allogeneic HCT conducted during complete remission (CR). Relapse occurred at a median of 6.1 months. The incidence rate of relapse peaked at 29.0 per 100 patient-years during the first 3–6 months period post transplant, after which the rate declined over time, and after 3 years remained consistently at less than 1 per 100 patient-years. The probability of overall survival (OS) after posttransplant relapse was 19% at 2 years, with 68% of deaths being attributed to leukemia. The interval from transplantation to relapse was identified as the strongest indicator for OS. Donor lymphocyte infusion (DLI) and second allogeneic HCT (HCT2) were administered to 152 (12%) and 481 (38%) patients, respectively. Landmark analyses showed some signs of survival benefit when these procedures were performed during CR, but no benefit was gained when performed during non-CR. Our findings clarify clinical features of posttransplant relapse of AML, and indicate the urgent need for developing effective bridging to cellular therapies.
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