期刊
LEUKEMIA RESEARCH
卷 41, 期 -, 页码 48-55出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.leukres.2015.12.009
关键词
Chronic myelomonocytic leukemia; Allogeneic hematopoietic stem cell transplantation; Graft-versus-host disease; Graft-versus-leukemia effect
资金
- Japanese Ministry of Health, Labor, and Welfare
- Ministry of Education, Culture, Sports, Science and Technology of Japan [26461426]
- Ministry of Health, Labour and Welfare of Japan [26300301-108]
- Grants-in-Aid for Scientific Research [26461426] Funding Source: KAKEN
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a therapeutic option that may lead to improved outcomes in patients with chronic myelomonocytic leukemia (CMML). However, few studies have examined the impact of the grade of graft-versus-host disease (GVHD) on post-transplant outcomes for CMML. We retrospectively analyzed the outcomes of 141 patients with CMML who underwent allo-HSCT between 1987 and 2010, and achieved neutrophil engraftment. The effects of acute GVHD (aGVHD) or chronic GVHD (cGVHD) on overall survival (OS), leukemia -associated mortality (LAM), and transplant-related mortality were evaluated by hazards regression models, in which the onset date of aGVHD or cGVHD was treated as a time-dependent covariate. Grade I aGVHD was associated with better OS and lower LAM (P=0.042, P=0.033, respectively) than no GVHD in univariate analyses, but not in the multivariate analyses. The multivariate analyses demonstrated that extensive cGVHD significantly associated with better OS (Hazard Ratio [HR] 0.35 [95% confidence intervals (CI), 0.16-0.74]; P= 0.007) and lower LAM (HR 0.36 [95% CI, 0.14-0.92]; P = 0.033) in patients who were not in complete remission at transplantation. In conclusion, the occurrence of cGVHD may be an important factor affecting the outcomes of CMML patients who received transplantation. (C) 2015 Elsevier Ltd. All rights reserved.
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