当前位置: X-MOL 学术 › Biol. Blood Marrow Transplant. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
The Role of Donor Lymphocyte Infusion (DLI) in Post-Hematopoietic Cell Transplant (HCT) Relapse for Chronic Myeloid Leukemia (CML) in the Tyrosine Kinase Inhibitor (TKI) Era.
Biology of Blood and Marrow Transplantation ( IF 5.609 ) Pub Date : 2020-02-14 , DOI: 10.1016/j.bbmt.2020.02.006
Sarah Schmidt 1 , Ying Liu 2 , Zhen-Huan Hu 3 , Kirsten M Williams 4 , Hillard M Lazarus 5 , Ravi Vij 6 , Mohamed A Kharfan-Dabaja 7 , Guillermo Ortí 8 , Peter H Wiernik 9 , Daniel Weisdorf 10 , Rammurti T Kamble 11 , Roger Herzig 12 , Baldeep Wirk 13 , Jan Cerny 14 , Ulrike Bacher 15 , Naeem A Chaudhri 16 , Sunita Nathan 17 , Nosha Farhadfar 18 , Mahmoud Aljurf 16 , Usama Gergis 19 , Jeffrey Szer 20 , Sachiko Seo 21 , Jack W Hsu 17 , Richard F Olsson 22 , Dipnarine Maharaj 23 , Biju George 24 , Gerhard C Hildebrandt 12 , Vaibhav Agrawal 25 , Taiga Nishihori 26 , Hisham Abdel-Azim 27 , Edwin Alyea 28 , Uday Popat 29 , Ronald Sobecks 30 , Bart L Scott 31 , Jennifer Holter Chakrabarty 1 , Wael Saber 3
Affiliation  

Treatment for relapse of chronic myeloid leukemia (CML) following hematopoietic cell transplantation (HCT) includes tyrosine kinase inhibitors (TKI) with or without donor lymphocyte infusions (DLI), however the most effective treatment strategy is unknown. This study was performed through the Center for International Blood and Marrow Transplant Research (CIBMTR) database. We retrospectively reviewed all patients reported to the CIBMTR registry from 2002-2014 who underwent HCT for CML and were alive 30 days post relapse. A total of 215 HCT recipients relapsed and were analyzed in the following groups 1) TKI alone n=128, 2) TKI with DLI n=48, and 3) DLI without TKI n=39. In multivariate analysis, disease status prior to HCT had a significant effect on overall survival (OS). Patients that received a DLI alone compared to a TKI with DLI had inferior survival HR 2.28 (95% CI 1.23-4.24; p = 0.009). Those who received TKI alone had similar survival compared to those who received TKI with DLI (p=0.81). These data supports that despite use of TKI pre-transplantation, TKI salvage therapy continues to provide significant survival following relapse in patients with CML following HCT. These data does not suggest that adding a DLI to TKI adds an improvement in OS.

中文翻译:

供体淋巴细胞输注 (DLI) 在酪氨酸激酶抑制剂 (TKI) 时代慢性粒细胞白血病 (CML) 造血细胞移植 (HCT) 后复发中的作用。

造血细胞移植 (HCT) 后慢性粒细胞白血病 (CML) 复发的治疗包括酪氨酸激酶抑制剂 (TKI),有或没有供体淋巴细胞输注 (DLI),但最有效的治疗策略尚不清楚。这项研究是通过国际血液和骨髓移植研究中心 (CIBMTR) 数据库进行的。我们回顾性审查了 2002 年至 2014 年报告给 CIBMTR 注册中心的所有患者,这些患者因 CML 接受了 HCT,并且在复发后 30 天仍然存活。总共 215 名 HCT 接受者复发并在以下组中进行了分析:1) 单独的 TKI n=128,2) 有 DLI 的 TKI n=48,和 3) 没有 TKI 的 DLI n=39。在多变量分析中,HCT 之前的疾病状态对总生存期 (OS) 有显着影响。与采用 DLI 的 TKI 相比,单独接受 DLI 的患者生存率较差,HR 2.28(95% CI 1.23-4.24;p = 0.009)。与接受 TKI 和 DLI 的患者相比,单独接受 TKI 的患者生存率相似(p=0.81)。这些数据支持,尽管在移植前使用了 TKI,但 TKI 挽救治疗继续为 HCT 后 CML 患者提供复发后显着的存活率。这些数据并不表明将 DLI 添加到 TKI 会增加操作系统的改进。
更新日期:2020-02-14
down
wechat
bug