Risk factors for outcome after allogeneic stem cell transplantation in patients with advanced phase CML

被引:18
作者
Niederwieser, Christian [1 ]
Morozova, Elena [2 ]
Zubarovskaya, Ludmila [2 ]
Zabelina, Tatjana [1 ]
Klyuchnikov, Evgeny [1 ]
Janson, Dietlinde [1 ]
Wolschke, Christine [1 ]
Christopeit, Maximilian [1 ]
Ayuk, Francis [1 ]
Moiseev, Ivan [2 ]
Afanasyev, Boris V. [2 ]
Kroger, Nicolaus [1 ]
机构
[1] Univ Med Ctr Hamburg Eppendorf, Dept Stem Cell Transplantat, Hamburg, Germany
[2] Raisa Gorbacheva Mem Inst Children Hematol & Tran, St Petersburg, Russia
关键词
CHRONIC MYELOID-LEUKEMIA; BONE-MARROW-TRANSPLANTATION; LONG-TERM SURVIVAL; CHRONIC MYELOGENOUS LEUKEMIA; MATCHED SIBLING DONORS; PROGNOSTIC-FACTORS; PERIPHERAL-BLOOD; UNRELATED DONORS; HEMATOPOIETIC CHIMERISM; HEMATOLOGIC MALIGNANCY;
D O I
10.1038/s41409-021-01410-x
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
Allogeneic hematopoietic stem-cell transplantation (HSCT) remains the only curative option for patients with advanced chronic myeloid leukemia (CML). However, outcome is dismal and of short follow-up. The objective of the study was to determine long-term outcome and risk factors in patients with a history of CML Blast Crisis (BC; n = 96) or accelerated phase (n = 51) transplanted between 1990 and 2018. At transplant, patients had a median age of 39 (range 7-76) years and were in >= CP2 (n = 70), in AP (n = 40) or in BC (n = 37) with a diagnosis-HSCT interval of median 1.9 (range 0.3-24.4) years. Overall survival (OS) amounted 34% (95% CI 22-46) and progression-free survival (PFS) 26% (95% CI 16-36) at 15 years. Adverse risk factors for OS and PFS were low CD34(+) count in the graft, donor age (>36 years) and BC. Cumulative incidence of Non-Relapse Mortality (NRM) was 28% (95% CI 18-38) and of relapse (RI) 43% (95% CI 33-53) at 15 years. PB-HSCT and HSCT after 2008 were favorable prognostic factors for NRM, while family donor and patient age >39 years were independently associated with higher RI. HSCT resulted in long-term OS in patients with advanced CML. OS was improved in non-BC patients, with donors <= 36 years and with higher CD34(+) dose in the graft.
引用
收藏
页码:2834 / 2841
页数:8
相关论文
共 37 条
[1]   The impact of the age of HLA-identical siblings on mobilization and collection of PBSCs for allogeneic hematopoietic cell transplantation [J].
Al-Ali, H. K. ;
Bourgeois, M. ;
Krahl, R. ;
Edel, E. ;
Leiblein, S. ;
Poenisch, W. ;
Basara, N. ;
Lange, T. ;
Niederwieser, D. .
BONE MARROW TRANSPLANTATION, 2011, 46 (10) :1296-1302
[2]   Quantitative assessment of hematopoietic chimerism after bone marrow transplantation by real-time quantitative polymerase chain reaction [J].
Alizadeh, M ;
Bernard, M ;
Danic, B ;
Dauriac, C ;
Birebent, B ;
Lapart, C ;
Lamy, T ;
Le Prisé, PY ;
Beauplet, A ;
Bories, D ;
Semana, G ;
Quelvennec, E .
BLOOD, 2002, 99 (12) :4618-4625
[3]   Mutation accumulation in cancer genes relates to nonoptimal outcome in chronic myeloid leukemia [J].
Awad, Shady Adnan ;
Kankainen, Matti ;
Ojala, Teija ;
Koskenvesa, Perttu ;
Eldfors, Samuli ;
Ghimire, Bishwa ;
Kumar, Ashwini ;
Kytola, Soili ;
Kamel, Mahmoud M. ;
Heckman, Caroline A. ;
Porkka, Kimmo ;
Mustjoki, Satu .
BLOOD ADVANCES, 2020, 4 (03) :546-559
[4]   European LeukemiaNet recommendations for the management of chronic myeloid leukemia: 2013 [J].
Baccarani, Michele ;
Deininger, Michael W. ;
Rosti, Gianantonio ;
Hochhaus, Andreas ;
Soverini, Simona ;
Apperley, Jane F. ;
Cervantes, Francisco ;
Clark, Richard E. ;
Cortes, Jorge E. ;
Guilhot, Francois ;
Hjorth-Hansen, Henrik ;
Hughes, Timothy P. ;
Kantarjian, Hagop M. ;
Kim, Dong-Wook ;
Larson, Richard A. ;
Lipton, Jeffrey H. ;
Mahon, Francois-Xavier ;
Martinelli, Giovanni ;
Mayer, Jiri ;
Mueller, Martin C. ;
Niederwieser, Dietger ;
Pane, Fabrizio ;
Radich, Jerald P. ;
Rousselot, Philippe ;
Saglio, Giuseppe ;
Saussele, Susanne ;
Schiffer, Charles ;
Silver, Richard ;
Simonsson, Bengt ;
Steegmann, Juan-Luis ;
Goldman, John M. ;
Hehlmann, Ruediger .
BLOOD, 2013, 122 (06) :872-884
[5]   Chronic Myeloid Leukemia: An Update of Concepts and Management Recommendations of European LeukemiaNet [J].
Baccarani, Michele ;
Cortes, Jorge ;
Pane, Fabrizio ;
Niederwieser, Dietger ;
Saglio, Giuseppe ;
Apperley, Jane ;
Cervantes, Francisco ;
Deininger, Michael ;
Gratwohl, Alois ;
Guilhot, Francois ;
Hochhaus, Andreas ;
Horowitz, Mary ;
Hughes, Timothy ;
Kantarjian, Hagop ;
Larson, Richard ;
Radich, Jerald ;
Simonsson, Bengt ;
Silver, Richard T. ;
Goldman, John ;
Hehlmann, Rudiger .
JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (35) :6041-6051
[6]   Association of CD34 cell dose with hematopoietic recovery, infections, and other outcomes after HLA-identical sibling bone marrow transplantation [J].
Bittencourt, H ;
Rocha, V ;
Chevret, S ;
Socié, G ;
Espérou, H ;
Devergie, A ;
Dal Cortivo, L ;
Marolleau, JP ;
Garnier, F ;
Ribaud, P ;
Gluckman, E .
BLOOD, 2002, 99 (08) :2726-2733
[7]   Final 5-Year Study Results of DASISION: The Dasatinib Versus Imatinib Study in Treatment-Naive Chronic Myeloid Leukemia Patients Trial [J].
Cortes, Jorge E. ;
Saglio, Giuseppe ;
Kantarjian, Hagop M. ;
Baccarani, Michele ;
Mayer, Jiri ;
Boque, Concepcion ;
Shah, Neil P. ;
Chuah, Charles ;
Casanova, Luis ;
Bradley-Garelik, Brigid ;
Manos, George ;
Hochhaus, Andreas .
JOURNAL OF CLINICAL ONCOLOGY, 2016, 34 (20) :2333-U54
[8]   Long-Term Survival after Transplantation of Unrelated Donor Peripheral Blood or Bone Marrow Hematopoietic Cells for Hematologic Malignancy [J].
Eapen, Mary ;
Logan, Brent R. ;
Appelbaum, Fredrick R. ;
Antin, Joseph H. ;
Anasetti, Claudio ;
Couriel, Daniel R. ;
Chen, Junfang ;
Maziarz, Richard T. ;
McCarthy, Philip L. ;
Nakamura, Ryotaro ;
Ratanatharathorn, Voravit ;
Vij, Ravi ;
Champlin, Richard E. .
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, 2015, 21 (01) :55-59
[9]   Real-time quantitative y chromosome-specific PCR (QYCS-PCR) for monitoring hematopoietic chimerism after sex-mismatched allogeneic stem cell transplantation [J].
Fehse, B ;
Chukhlovin, A ;
Kühlcke, K ;
Marinetz, O ;
Vorwig, O ;
Renges, H ;
Krüger, W ;
Zabelina, T ;
Dudina, O ;
Finckenstein, FG ;
Kröger, N ;
Kabisch, H ;
Hochhaus, A ;
Zander, AR .
JOURNAL OF HEMATOTHERAPY & STEM CELL RESEARCH, 2001, 10 (03) :419-425
[10]   Clonal Hematopoiesis and Blood-Cancer Risk Inferred from Blood DNA Sequence [J].
Genovese, Giulio ;
Kaehler, Anna K. ;
Handsaker, Robert E. ;
Lindberg, Johan ;
Rose, Samuel A. ;
Bakhoum, Samuel F. ;
Chambert, Kimberly ;
Mick, Eran ;
Neale, Benjamin M. ;
Fromer, Menachem ;
Purcell, Shaun M. ;
Svantesson, Oscar ;
Landen, Mikael ;
Hoeglund, Martin ;
Lehmann, Soeren ;
Gabriel, Stacey B. ;
Moran, Jennifer L. ;
Lander, Eric S. ;
Sullivan, Patrick F. ;
Sklar, Pamela ;
Groenberg, Henrik ;
Hultman, Christina M. ;
McCarroll, Steven A. .
NEW ENGLAND JOURNAL OF MEDICINE, 2014, 371 (26) :2477-2487