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Blastic plasmacytoid dendritic cell neoplasm with leukemic presentation: an Italian multicenter study
被引:251
作者:
Pagano, Livio
[1
]
Valentini, Caterina Giovanna
[1
]
Pulsoni, Alessandro
[2
]
Fisogni, Simona
[3
]
Carluccio, Paola
[4
]
Mannelli, Francesco
[5
]
Lunghi, Monia
[6
]
Pica, Gianmatteo
[7
]
Onida, Francesco
[8
]
Cattaneo, Chiara
[9
]
Piccaluga, Pier Paolo
[10
]
Di Bona, Eros
[11
]
Todisco, Elisabetta
[12
]
Musto, Pellegrino
[13
]
Spadea, Antonio
[14
]
D'Arco, Alfonso
[15
]
Pileri, Stefano
[10
]
Leone, Giuseppe
[1
]
Amadori, Sergio
[16
]
Facchetti, Fabio
[3
]
机构:
[1] Univ Cattolica Sacro Cuore, Inst Hematol, I-00168 Rome, Italy
[2] Univ Roma La Sapienza, Inst Hematol, Rome, Italy
[3] Univ Brescia, Dept Pathol, I-25121 Brescia, Italy
[4] Univ Bari, Div Hematol, I-70121 Bari, Italy
[5] Univ Florence, Dept Hematol, I-50121 Florence, Italy
[6] Amedeo Avogadro Univ Eastern Piedmont, Div Hematol, Novara, Italy
[7] Hosp San Martino Genova, Dept Hematol, Genoa, Italy
[8] Univ Milan, Fdn IRCCS Ca Granda Osped Maggiore Policlin, UO Ematol CTMO 1, I-20122 Milan, Italy
[9] Spedali Civil Brescia, Dept Hematol, I-25125 Brescia, Italy
[10] Univ Bologna, Dept Hematol & Oncol Sci L&A Seragnoli, I-40126 Bologna, Italy
[11] San Bortolo Hosp, Dept Cellular Therapy & Haematol, Vicenza, Italy
[12] Humanitas Canc Ctr IRCCS, Hematol Unit, Milan, Italy
[13] IRCCS CROB, Div Hematol, Rionero In Vulture, Italy
[14] Regina Elena Inst Canc Res, Div Hematol, Rome, Italy
[15] Nocera Inferiore, Divis Hematol, Rome, Italy
[16] Tor Vergata Univ Hosp, Dept Hematol, Rome, Italy
关键词:
HEMATODERMIC NEOPLASM;
CUTANEOUS INVOLVEMENT;
TRANSPLANTATION;
FEATURES;
CRITERIA;
LINEAGE;
CD4(+);
SERIES;
TUMOR;
D O I:
10.3324/haematol.2012.072645
中图分类号:
R5 [内科学];
学科分类号:
1002 ;
100201 ;
摘要:
The objective of this study was to evaluate the clinical features, prognostic factors, and efficacy of treatments in patients with blastic plasmacytoid dendritic cell neoplasm with a leukemic presentation at onset of the disease. In order to do this, a retrospective multicenter study was performed from 2005-2011 in 28 Italian hematology divisions in which 43 cases were collected. Forty-one patients received an induction therapy, consisting of an acute myeloid leukemia-type regimen in 26 patients (60%) and acute lymphoid leukemia/lymphoma-type regimen in 15 patients (35%). Six patients (14%) underwent allogeneic hematopoietic stem cell transplantation. Seventeen patients (41%) achieved a complete remission: seven after acute myeloid leukemia-type treatment and 10 after an acute lymphoid leukemia/lymphoma-type regimen, with a significant advantage for acute lymphoid leukemia/lymphoma-type chemotherapy (P=0.02). Relapse occurred in six of the 17 patients (35%) who achieved complete remission, more frequently after acute lymphoid leukemia/lymphoma-type chemotherapy. The median overall survival was 8.7 months (range, 0.2-32.9). The patients treated with an acute myeloid leukemia-type regimen had an overall survival of 7.1 months (range, 0.2-19.5), whereas that of the patients receiving acute lymphoid leukemia/lymphoma-type chemotherapy was 12.3 months (range, 1-32.9) (P=0.02). The median overall survival of the allogeneic hematopoietic stem cell transplant recipients was 22.7 months (range, 12-32.9), and these patients had a significant survival advantage compared to the non-transplanted patients (median 7.1 months, 0.2-21.3; P=0.03). In conclusion, blastic plasmacytoid dendritic cell neoplasm with bone-marrow involvement is an aggressive subtype of high-risk acute leukemia. The rarity of this disease does not enable prospective clinical trials to identify the better therapeutic strategy, which, at present, is based on clinicians' experience.
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页码:239 / 246
页数:8
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