同种异体造血干细胞移植治疗骨髓增生异常/骨髓增生性重叠肿瘤的疗效。

IF 2.3 3区医学 Q2 HEMATOLOGY

European Journal of Haematology Pub Date : 2025-05-07 DOI:10.1111/ejh.14430

Nihar Desai, Sergio Rodriguez-Rodriguez, Carol Chen, Tommy Alfaro Moya, Eshrak Al-Shaibani, Igor Novitzky-Basso, Ivan Pasic, Fotios V Michelis, Auro Viswabandya, Dennis Kim, Rajat Kumar, Jonas Mattsson, Arjun Datt Law

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引用次数: 0

摘要

骨髓增生异常/骨髓增生性重叠瘤（MDS/MPN）是一种罕见的血液系统恶性肿瘤。我们分析了75例接受同种异体造血干细胞移植治疗MDS/MPN的患者的结果。移植物抗宿主病（GvHD）的预防包括71%的患者在移植后使用环磷酰胺（PTCy）， 44%（59%）的患者接受抗胸腺细胞球蛋白（ATG）和PTCy的联合治疗。中位随访时间为44.4个月。3例（4%）患者发生原发性移植物衰竭。第100天III-IV级急性GvHD的发生率为13% （95% CI: 6-22）。2年后，中重度慢性GvHD的发病率、非复发死亡率（NRM）、复发、无GvHD /无复发生存率（GRFS）和总生存率（OS）分别为31.7% （95% CI 20.7-43.2）、37.9%（26-49）、17.4% （95% CI: 10-27）、24.8% （95% CI: 15-36）和51.6% （95% CI: 39-63）。基于ptcy的GvHD预防似乎与改善OS （HR: 0.5, 95% CI: 0.3-0.9, p = 0.03）、NRM （HR: 0.4, 95% CI: 0.2-0.9, p = 0.03）和GRFS （HR: 0.5, 95% CI: 0.3-0.8, 0.009）相关。在多变量分析中，使用含ptcy方案似乎与改善NRM相关(HR: 0.41；95% ci: 0.2-0.8；p = 0.03), GRFS (HR: 0.47；95% ci: 0.3-0.8；p = 0.009), OS (HR: 0.49；95% ci: 0.2-0.9；P = 0.03)，复发风险未增加。

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Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation for Myelodysplastic/Myeloproliferative Overlap Neoplasms.

Myelodysplastic/myeloproliferative overlap neoplasms (MDS/MPN) are rare hematological malignancies. We analyzed the outcomes of 75 patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) for MDS/MPN. Graft-versus-host disease (GvHD) prophylaxis included post-transplantation cyclophosphamide (PTCy) in 71% of patients, with 44 (59%) receiving a combination of anti-thymocyte globulin (ATG) and PTCy. The median follow-up was 44.4 months. Primary graft failure occurred in three patients (4%). The incidence of grade III-IV acute GvHD at day 100 was 13% (95% CI: 6-22). At 2 years, the incidence of moderate-severe chronic GvHD, non-relapse mortality (NRM), relapse, GvHD-free/relapse-free survival (GRFS), and overall survival (OS) was 31.7% (95% CI 20.7-43.2), 37.9% (26-49), 17.4% (95% CI: 10-27), 24.8% (95% CI: 15-36), and 51.6% (95% CI: 39-63), respectively. PTCy-based GvHD prophylaxis seemed to be associated with improved OS (HR: 0.5, 95% CI: 0.3-0.9, p = 0.03), NRM (HR: 0.4, 95% CI: 0.2-0.9, p = 0.03), and GRFS (HR: 0.5, 95% CI: 0.3-0.8, 0.009). On multivariable analysis, the use of the PTCy-containing regimen seemed to be associated with improved NRM (HR: 0.41; 95% CI: 0.2-0.8; p = 0.03), GRFS (HR: 0.47; 95% CI: 0.3-0.8; p = 0.009), and OS (HR: 0.49; 95% CI: 0.2-0.9; p = 0.03) without an increased risk of relapse.

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来源期刊

European Journal of Haematology 医学-血液学

CiteScore

5.50

自引率

0.00%

发文量

168

审稿时长

4-8 weeks

期刊介绍： European Journal of Haematology is an international journal for communication of basic and clinical research in haematology. The journal welcomes manuscripts on molecular, cellular and clinical research on diseases of the blood, vascular and lymphatic tissue, and on basic molecular and cellular research related to normal development and function of the blood, vascular and lymphatic tissue. The journal also welcomes reviews on clinical haematology and basic research, case reports, and clinical pictures.