典型文献
Haploidentical transplantation has a superior graft-versus-leukemia effect than HLA-matched sibling transplantation for Ph- high-risk B-cell acute lymphoblastic leukemia
文献摘要：
Background::Compared with human leukocyte antigen (HLA)-matched sibling donor (MSD) transplantation, it remains unclear whether haploidentical donor (HID) transplantation has a superior graft-versus-leukemia (GVL) effect for Philadelphia-negative (Ph-) high-risk B-cell acute lymphoblastic leukemia (B-ALL). This study aimed to compare the GVL effect between HID and MSD transplantation for Ph- high-risk B-ALL.Methods::This study population came from two prospective multicenter trials (NCT01883180, NCT02673008). Immunosuppressant withdrawal and prophylactic or pre-emptive donor lymphocyte infusion (DLI) were administered in patients without active graft-versus-host disease (GVHD) to prevent relapse. All patients with measurable residual disease (MRD) positivity posttransplantation (post-MRD+) or non-remission (NR) pre-transplantation received prophylactic/pre-emptive interventions. The primary endpoint was the incidence of post-MRD+.Results::A total of 335 patients with Ph- high-risk B-ALL were enrolled, including 145 and 190, respectively, in the HID and MSD groups. The 3-year cumulative incidence of post-MRD+ was 27.2% (95% confidence interval [CI]: 20.2%-34.7%) and 42.6% (35.5%-49.6%) in the HID and MSD groups
(P = 0.003), respectively. A total of 156 patients received DLI, including 60 (41.4%) and 96 (50.5%), respectively, in the HID and MSD groups (
P= 0.096). The 3-year cumulative incidence of relapse was 18.6% (95% CI: 12.7%-25.4%) and 25.9% (19.9%-32.3%;
P = 0.116) in the two groups, respectively. The 3-year overall survival (OS) was 67.4% (95% CI: 59.1%-74.4%) and 61.6% (54.2%-68.1%;
P = 0.382), leukemia-free survival (LFS) was 63.4% (95% CI: 55.0%-70.7%) and 58.2% (50.8%-64.9%;
P= 0.429), and GVHD-free/relapse-free survival (GRFS) was 51.7% (95% CI: 43.3%-59.5%) and 37.8% (30.9%-44.6%;
P= 0.041), respectively, in the HID and MSD groups.
Conclusion::HID transplantation has a lower incidence of post-MRD+ than MSD transplantation, suggesting that HID transplantation might have a superior GVL effect than MSD transplantation for Ph- high-risk B-ALL patients.Trial registration::ClinicalTrials.gov: NCT01883180, NCT02673008.
文献关键词：
Haploidentical;HLA-matched sibling;Philadelphia-negative high-risk B-cell acute lymphoblastic leukemia;Graft-versus-leukemia;Transplantation
中图分类号：
作者姓名：
Fan Menglin;Wang Yu;Lin Ren;Lin Tong;Huang Fen;Fan Zhiping;Xu Yajing;Yang Ting;Xu Na;Shi Pengcheng;Nie Danian;Lin Dongjun;Jiang Zujun;Wang Shunqing;Sun Jing;Huang Xiaojun;Liu Qifa;Xuan Li
作者机构：
Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China;Department of Hematology, Peking University People’s Hospital, Peking University Institute of Hematology, Beijing 100044, China;Department of Hematology, Xiangya Hospital, Central South University, Changsha, Hunan 110051, China;Department of Hematology, Fujian Institute of Hematology, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, China;Department of Hematology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510130, China;Department of Hematology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510630, China;Department of Hematology, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong 510010, China;Department of Hematology, Guangzhou First People’s Hospital, Guangzhou, Guangdong 510080, China
文献出处：
引用格式：
[1]Fan Menglin;Wang Yu;Lin Ren;Lin Tong;Huang Fen;Fan Zhiping;Xu Yajing;Yang Ting;Xu Na;Shi Pengcheng;Nie Danian;Lin Dongjun;Jiang Zujun;Wang Shunqing;Sun Jing;Huang Xiaojun;Liu Qifa;Xuan Li-.Haploidentical transplantation has a superior graft-versus-leukemia effect than HLA-matched sibling transplantation for Ph- high-risk B-cell acute lymphoblastic leukemia)[J].中华医学杂志（英文版）,2022(08):930-939
A类：
Haploidentical,NCT01883180,NCT02673008,Immunosuppressant,MRD+,GRFS
B类：
has,superior,graft,versus,leukemia,effect,than,HLA,matched,sibling,high,risk,cell,acute,lymphoblastic,Background,Compared,human,leukocyte,antigen,donor,MSD,remains,unclear,whether,haploidentical,HID,GVL,Philadelphia,negative,ALL,This,study,aimed,compare,between,Methods,population,came,from,two,prospective,multicenter,trials,withdrawal,prophylactic,emptive,lymphocyte,infusion,DLI,were,administered,patients,without,active,host,disease,GVHD,prevent,relapse,All,measurable,residual,positivity,posttransplantation,remission,NR,received,interventions,primary,endpoint,was,incidence,Results,total,enrolled,including,respectively,groups,year,cumulative,confidence,interval,overall,survival,OS,free,LFS,Conclusion,lower,suggesting,that,might,have,registration,ClinicalTrials,gov,Graft,Transplantation
AB值：
0.364763
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