青少年和年轻人异基因造血干细胞移植后早期t前体与非etp急性淋巴细胞白血病治疗结果和预后因素的比较分析

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-03-17 DOI:10.1016/j.transproceed.2025.02.029

Chengsen Cai , Huizhu Kang , Peng Ke , Mengjie Cai , Ming Gao , Chengyuan Gu , Ruju Wang , Jiaqian Qi , Depei Wu , Yue Han

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引用次数: 0

摘要

本研究评估了诊断为早期t前体（ETP）急性淋巴细胞白血病（ALL）的青少年和年轻人（AYA）与非ETP急性淋巴细胞白血病（ALL）的异基因造血干细胞移植（alloo - hsct）的结果和相关危险因素。我们回顾性分析了2014年9月至2022年12月期间接受治疗的178例AYA合并T-ALL患者。178例患者中，128例接受了同种异体造血干细胞移植，中位年龄为25岁（范围：18-35岁）。其中，ETP组49例，非ETP组79例。各组间中性粒细胞和血小板植入时间具有可比性。ETP患者3年OS率为67.3%，非ETP患者为65.8%；3年LFS率分别为65.3%和65.8%，差异无统计学意义。累积复发率（22.1%对21.6%）和非复发死亡率（17.8%对13.7%）相似。急性和慢性GVHD的发病率，以及感染，没有显着差异。多变量分析显示，移植前首次完全缓解是非etp患者OS和LFS的积极预测因子。在ETP患者中，白细胞计数低于30 × 109/L预示着更好的LFS结果。血红蛋白水平低于120 g/L与非etp患者OS改善独立相关。Allo-HSCT可有效改善ETP-ALL患者的预后，其生存结果与非ETP-ALL患者相当。

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Comparative Analysis of Treatment Outcomes and Prognostic Factors in Early T-Precursor Versus Non-ETP Acute Lymphoblastic Leukemia Following Allogeneic Hematopoietic Stem Cell Transplantation in Adolescents and Young Adults

This study evaluates the outcomes and risk factors associated with allogeneic hematopoietic stem cell transplantation (allo-HSCT) in adolescents and young adults (AYA) diagnosed with early T-precursor (ETP) acute lymphoblastic leukemia (ALL) compared to non-ETP ALL.We retrospectively analyzed 178 AYA patients with T-ALL who were treated between September 2014 and December 2022. Out of 178 patients, 128 underwent allo-HSCT, with a median age of 25 years (range: 18-35). Among them, 49 were in the ETP group and 79 in the non-ETP group. Neutrophil and platelet engraftment times were comparable between groups. 3-year OS rates were 67.3% for ETP and 65.8% for non-ETP patients; 3-year LFS rates were 65.3% and 65.8%, respectively, showing no significant difference. Cumulative incidence of relapse (22.1% vs. 21.6%) and non-relapse mortality rates (17.8% vs. 13.7%) were similar. The incidence of acute and chronic GVHD, along with infections, showed no significant differences. Multivariable analysis revealed first complete remission before transplantation as a positive predictor for OS and LFS in non-ETP patients. In ETP patients, a white blood cell count below 30 × 10⁹/L predicted better LFS outcomes. A hemoglobin level below 120 g/L was independently associated with improved OS in non-ETP patients. Allo-HSCT offers effective improvement in prognosis for ETP-ALL, with survival outcomes comparable to non-ETP ALL patients.

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.