当前位置: X-MOL 学术Haematologica › 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.)
Comparison of autologous and allogeneic hematopoietic cell transplantation strategies in patients with primary plasma cell leukemia, with dynamic prediction modelling.
Haematologica ( IF 10.1 ) Pub Date : 2022-06-30 , DOI: 10.3324/haematol.2021.280568
Sarah Lawless 1 , Simona Iacobelli 2 , Nina Simone Knelange 3 , Patrice Chevallier 4 , Didier Blaise 5 , Noel Milpied 6 , Roberto Foà 7 , Jan J Cornelissen 8 , Bruno Lioure 9 , Ruben Benjamin 10 , Xavier Poiré 11 , Monique C Minnema 12 , Matthew Collin 13 , Stig Lenhoff 14 , John A Snowden 15 , Stella Santarone 16 , Keith M O Wilson 17 , Fernanda Trigo 18 , Peter Dreger 19 , Lara H Böhmer 20 , Hein Putter 21 , Laurent Garderet 22 , Nicolaus Kröger 23 , Ibrahim Yaukoub-Agha 24 , Stefan Schönland 19 , Curly Morris 25
Affiliation  

Primary Plasma Cell Leukaemia (pPCL) is a rare and challenging malignancy. There is limited data regarding optimum transplant approaches. Therefore we undertook a retrospective analysis from 1998-2014 of 751 patients with Primary Plasma Cell Leukaemia (pPCL) undergoing one of four transplant strategies; single autologous transplant (single-auto), single allogeneic transplant (allo-first) or a combined tandem transplant either auto-allo or auto-auto. To avoid time bias multiple analytic approaches were employed including Cox models with time dependent covariates and dynamic prediction by landmarking. Initial comparisons were made between patients undergoing allo-first (n=70) versus auto first (n=681), regardless of subsequent administration of second transplant. The allo-first group had lower relapse rate (45.9%, 95%CI 33.2-58.6 vs. 68.4%, 64.4-72.4) but higher NRM (27%, 95%CI 15.9-38.1 vs 7.3%, 5.2-9.4) at 36 months. Allo-first had remarkably higher risk in the first 100 days for both OS and PFS. Autoallo (n=122) had no increased risk in the short term and significant benefit in PFS post-100 days compared to single auto (HR 0.69, 95%CI: 0.52-0.92, p=0.012). Auto-auto (n=117) was an effective option for patients achieving CR prior to first transplant, whereas in patients without CR prior to transplant our modelling predicted that auto-allo was superior. This is the largest retrospective study reporting on transplant in pPCL to date. We confirm significant mortality risk within the first 100 days for allo-first and suggest that tandem transplant strategies are superior. Disease status at time of transplant influences outcome, this knowledge may help guide clinical decisions on transplant strategy.

中文翻译:

原发性浆细胞白血病患者自体和同种异体造血细胞移植策略的比较,以及动态预测模型。

原发性浆细胞白血病 (pPCL) 是一种罕见且具有挑战性的恶性肿瘤。关于最佳移植方法的数据有限。因此,我们对 1998-2014 年接受四种移植策略之一的 751 名原发性浆细胞白血病 (pPCL) 患者进行了回顾性分析;单次自体移植(single-auto)、单次同种异体移植(allo-first)或联合串联移植(auto-allo 或 auto-auto)。为了避免时间偏差,采用了多种分析方法,包括具有时间相关协变量的 Cox 模型和通过标记进行动态预测。初步比较了接受同种异体移植(n=70)与首先接受自身移植(n=681)的患者,无论随后是否进行第二次移植。allo-first 组的复发率较低(45.9%,95%CI 33.2-58.6 vs. 68.4%,64.4-72. 4) 但 36 个月时 NRM 更高(27%,95%CI 15.9-38.1 对比 7.3%,5.2-9.4)。Allo-first 在前 100 天的 OS 和 PFS 风险都非常高。Autoallo (n=122) 在短期内没有增加风险,与单一汽车相比,100 天后的 PFS 有显着益处 (HR 0.69, 95%CI: 0.52-0.92, p=0.012)。Auto-auto (n=117) 是首次移植前达到 CR 的患者的有效选择,而对于移植前未达到 CR 的患者,我们的模型预测 auto-allo 更优。这是迄今为止最大的 pPCL 移植回顾性研究报告。我们确认同种异体优先在前 100 天内有显着的死亡风险,并表明串联移植策略更优越。移植时的疾病状况会影响结果,
更新日期:2022-06-30
down
wechat
bug