典型文献
Haploidentical hematopoietic stem cell transplantation may improve long-term survival for children with high-risk T-cell acute lymphoblastic leukemia in first complete remission
文献摘要：
Background::The role of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children with high-risk (HR) T-cell acute lymphoblastic leukemia (T-ALL) in first complete remission (CR1) is still under evaluation. Moreover, relapse is the main factor affecting survival. This study aimed to explore the effect of allo-HSCT (especially haploidentical HSCT [haplo-HSCT]) on improving survival and reducing relapse for HR childhood T-ALL in CR1 and the prognostic factors of childhood T-ALL in order to identify who could benefit from HSCT.Methods::A total of 74 newly diagnosed pediatric T-ALL patients between January 1, 2012 and June 30, 2018 were enrolled in this retrospective study. Patients were stratified into the low-risk chemotherapy cohort (
n = 16), HR chemotherapy cohort (
n = 31), and HR transplant cohort (
n = 27). Characteristics, survival outcomes, and prognostic factors of all patients were then analyzed.
Results::Patient prognosis in the HR chemotherapy cohort was significantly worse than that in the low-risk chemotherapy cohort (5-year overall survival [OS]: 58.5%
vs. 100%,
P = 0.003; 5-year event-free survival [EFS]: 54.1%
vs. 83.4%,
P = 0.010; 5-year cumulative incidence of relapse [CIR]: 45.2%
vs. 6.3%,
P = 0.011). In HR patients, allo-HSCT improved the 5-year EFS and CIR compared to that of chemotherapy (5-year EFS: 80.1%
vs. 54.1%,
P = 0.041; 5-year CIR: 11.6%
vs. 45.2%,
P = 0.006). The 5-year OS was higher in the HR transplant cohort than that in the HR chemotherapy cohort (81.0%
vs. 58.5%,
P = 0.084). Minimal residual disease re-emergence was an independent risk factor for 5-year OS, EFS, and CIR; age ≥10 years was an independent risk factor for OS and EFS; and high white blood cell count was an independent risk factor for EFS and CIR.
Conclusion::Allo-HSCT, especially haplo-HSCT, could effectively reduce relapse of children with HR T-ALL in CR1.
文献关键词：
T-cell acute lymphoblastic leukemia;Allogeneic hematopoietic stem cell transplantation;Haploidentical;Minimal residual disease;Children
中图分类号：
作者姓名：
Zhang Yongzhan;Bai Lu;Cheng Yifei;Lu Aidong;Wang Yu;Wu Jun;Zhang Xiaohui;Zuo Yingxi;Xu Lanping;Jia Yueping;Huang Xiaojun;Zhang Leping
作者机构：
Department of Pediatrics, Peking University People’s Hospital, Peking University, Beijing 100044, China;Department of Hematology, Peking University People’s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China;Department of Pediatrics, Peking University Shougang Hospital, Peking University, Beijing 100144, China;Department of Research Unit of Key Technique for Diagnosis and Treatments of Hematologic Malignancies, Chinese Academy of Medical Sciences, 2019RU029, Beijing, China
文献出处：
引用格式：
[1]Zhang Yongzhan;Bai Lu;Cheng Yifei;Lu Aidong;Wang Yu;Wu Jun;Zhang Xiaohui;Zuo Yingxi;Xu Lanping;Jia Yueping;Huang Xiaojun;Zhang Leping-.Haploidentical hematopoietic stem cell transplantation may improve long-term survival for children with high-risk T-cell acute lymphoblastic leukemia in first complete remission)[J].中华医学杂志（英文版）,2022(08):940-949
A类：
Haploidentical
B类：
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AB值：
0.382896
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