期刊
BONE MARROW TRANSPLANTATION
卷 56, 期 9, 页码 2108-2117出版社
SPRINGERNATURE
DOI: 10.1038/s41409-021-01261-6
关键词
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资金
- Public Health Service from the National Cancer Institute (NCI) [U24CA076518]
- Public Health Service from the National Heart, Lung and Blood Institute (NHLBI) [U24CA076518]
- Public Health Service from the National Institute of Allergy and Infectious Diseases (NIAID) [U24CA076518]
- NHLBI [U24HL138660, OT3HL147741, U01HL128568]
- NCI [U24HL138660]
- Health Resources and Services Administration (HRSA) [HHSH250201700006C, HHSH250201700007C]
- Office of Naval Research [N00014-20-1-2705, N00014-20-12832]
- BARDA
- Be the Match Foundation
- Boston Children's Hospital
- Dana Farber
- St. Baldrick's Foundation
- Stanford University
- Medical College of Wisconsin the National Marrow Donor Program
- Actinium Pharmaceuticals, Inc.
- Adienne SA
- Allovir, Inc.
- Amgen, Inc.
- Angiocrine Bioscience
- Astellas Pharma US
- bluebird bio, Inc.
- Bristol Myers Squibb Co.
- Celgene Corp.
- CSL Behring
- CytoSen Therapeutics, Inc.
- Daiichi Sankyo Co., Ltd.
- ExcellThera
- Fate Therapeutics
- Gamida-Cell, Ltd.
- Genentech Inc
- Incyte Corporation
- Janssen/Johnson Johnson
- Jazz Pharmaceuticals, Inc.
- Kiadis Pharma
- Kite, a Gilead Company
- Kyowa Kirin
- Legend Biotech
- Magenta Therapeutics
- Merck Sharp Dohme Corp.
- Millennium, the Takeda Oncology Co.
- Miltenyi Biotec, Inc.
- Novartis Pharmaceuticals Corporation
- Omeros Corporation
- Oncoimmune, Inc.
- Orca Biosystems, Inc.
- Pfizer, Inc.
- Pharmacyclics, LLC
- Sanofi Genzyme
- Stemcyte
- Takeda Pharma
- Vor Biopharma
- Xenikos BV
- [P01CA111412]
- [R01CA152108]
- [R01CA215134]
- [R01CA218285]
- [R01CA231141]
- [R01AI128775]
- [R01HL126589]
- [R01HL129472]
- [R01HL130388]
- [R01HL131731]
- [U01AI069197]
- [U01AI126612]
- [UG1HL06924]
The study found that in AML patients, those in CRi had increased risk of death compared to those in CR, along with higher non-relapse mortality, shorter disease-free survival, and increased relapse. Detectable MRD was associated with shorter overall survival, shorter disease-free survival, higher non-relapse mortality, and increased relapse. The detrimental effects of CRi and MRD were independent.
Acute myeloid leukemia (AML) patients often undergo allogeneic hematopoietic cell transplantation (alloHCT) in first complete remission (CR). We examined the effect of depth of clinical response, including incomplete count recovery (CRi) and/or measurable residual disease (MRD), in patients from the Center for International Blood and Marrow Transplantation Research (CIBMTR) registry. We identified 2492 adult patients (1799 CR and 693 CRi) who underwent alloHCT between January 1, 2007 and December 31, 2015. The primary outcome was overall survival (OS). Multivariable analysis was performed to adjust for patient-, disease-, and transplant-related factors. Baseline characteristics were similar. Patients in CRi compared to those in CR had an increased likelihood of death (HR: 1.27; 95% confidence interval: 1.13-1.43). Compared to CR, CRi was significantly associated with increased non-relapse mortality (NRM), shorter disease-free survival (DFS), and a trend toward increased relapse. Detectable MRD was associated with shorter OS, shorter DFS, higher NRM, and increased relapse compared to absence of MRD. The deleterious effects of CRi and MRD were independent. In this large CIBMTR cohort, survival outcomes differ among AML patients based on depth of CR and presence of MRD at the time of alloHCT. Further studies should focus on optimizing post-alloHCT outcomes for patients with responses less than CR.
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