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学科主题: 临床医学
题名:
Extramedullary Relapse of Acute Leukemia after Haploidentical Hematopoietic Stem Cell Transplantation: Incidence, Risk Factors, Treatment, and Clinical Outcomes
作者: Mo, Xiao-Dong1,2; Kong, Jun1,2; Zhao, Ting1,2; Xu, Lan-Ping1,2; Zhang, Xiao-Hui1,2; Liu, Dai-Hong1,2; Wang, Yu1,2; Chen, Huan1,2; Yan, Chen-Hua1,2; Chen, Yu-Hong1,2; Han, Wei1,2; Wang, Feng-Rong1,2; Wang, Jing-Zhi1,2; Liu, Kai-Yan1,2; Huang, Xiao-Jun1,2,3
关键词: Extramedullary relapse ; Chronic graft-versus-host disease ; Hematopoietic stem cell transplantation ; Haploidentical ; Acute leukemia
刊名: BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
发表日期: 2014-12-01
DOI: 10.1016/j.bbmt.2014.08.023
卷: 20, 期:12, 页:2023-2028
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Hematology ; Immunology ; Transplantation
研究领域[WOS]: Hematology ; Immunology ; Transplantation
关键词[WOS]: BONE-MARROW-TRANSPLANTATION ; ACUTE MYELOID-LEUKEMIA ; ACUTE LYMPHOBLASTIC-LEUKEMIA ; VERSUS-HOST-DISEASE ; ACUTE MYELOGENOUS LEUKEMIA ; TERM-FOLLOW-UP ; GRANULOCYTIC SARCOMA ; RANDOMIZED-TRIAL ; SINGLE-CENTER ; CHRONIC GRAFT
英文摘要:

We examined the incidence, risk factors, treatment, and clinical outcomes of extramedullary relapse (EMR) in 961 acute leukemia patients undergoing HLA-haploidentical hematopoietic stem cell transplantation (haplo-HSCT) between 2002 and 2013. Multiple control subjects were selected at random from the same cohort and matched to EMR cases for diagnosis, disease status at HSCT, age at the time of the HSCT, and year of HSCT. Forty patients exhibited EMR, with a median time to EMR of 207 days. The cumulative incidence of EMR was 4.0% at 3 years, and the incidence was higher in acute lymphoblastic leukemia patients compared with acute myeloid leukemia patients (5.6% versus 2.4%). In the multivariate analysis, non complete remission (CR) status at HSCT (hazard ratio [HR] = 4.6; P = .018) and non chronic graft-versus-host disease after HSCT (HR = 3.2; P < .001) were the independent risk factors for EMR after haplo-HSCT. Twenty-seven patients received combination treatments, and the proportion of patients who achieved CR was higher than those who received single treatment. Multifocal involvement at EMR (HR = 2.7; P = .024) and non-CR after EMR treatments (HR = 4.6; P < .001) were the independent risk factors for poor survival rates among EMR patients. We found that graft-versus-leukemia effect may help to prevent EMR after haplo-HSCT. (C) 2014 American Society for Blood and Marrow Transplantation.

语种: 英语
所属项目编号: Z111107067311070 ; Z121107001012085 ; 81230013
项目资助者: Beijing Municipal Science and Technology Program ; Clinical Characteristic Study of Capital Project ; Key Program of the National Natural Science Foundation of China
WOS记录号: WOS:000345606500023
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/58173
Appears in Collections:北京大学第二临床医学院_期刊论文

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作者单位: 1.Peking Univ, Peoples Hosp, Beijing 100044, Peoples R China
2.Peking Univ, Inst Hematol, Beijing Key Lab Hematopoiet Stem Cell Transplanta, Beijing 100044, Peoples R China
3.Peking Tsinghua Ctr Life Sci, Beijing, Peoples R China

Recommended Citation:
Mo, Xiao-Dong,Kong, Jun,Zhao, Ting,et al. Extramedullary Relapse of Acute Leukemia after Haploidentical Hematopoietic Stem Cell Transplantation: Incidence, Risk Factors, Treatment, and Clinical Outcomes[J]. BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION,2014,20(12):2023-2028.
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