骨髓纤维化对急性髓系白血病异基因造血干细胞移植结局的影响。
Impact of bone marrow fibrosis on outcomes of allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia.
发表日期：2024 Aug 27
作者：
Haixiao Zhang, Wenwen Guo, Jiali Wang, Ni Lu, Xinhui Zheng, Qi Sun, Yonghui Xia, Rongli Zhang, Xin Chen, Qiaoling Ma, Donglin Yang, Aiming Pang, Jialin Wei, Yi He, Sizhou Feng, Mingzhe Han, Weihua Zhai, Erlie Jiang
来源：
Experimental Hematology & Oncology
摘要：
病因不明的骨髓纤维化（BMF）在血液系统恶性肿瘤中很常见，但其对急性髓系白血病（AML）的预后价值尚不清楚。我们询问了 532 名新诊断的 AML 受试者接受同种异体血液干细胞移植的数据，以评估 BMF 对移植结果的预后影响。根据诊断时 BMF 分级的欧洲共识，255 名受试者 (48%) 为 BMF-0、209 名受试者 (39%)、BMF-1 和 68 名受试者 (13%) 为 BMF-2-3。患有BMF-2-3的受试者总体生存率较差（P<0.001），无病生存率（P<0.001）且复发率较高（CIR，P<0.001）。移植前完全缓解受试者的多变量分析显示，BMF-2-3 是 CIR 的独立危险因素（风险比 [HR] = 2.17，（95% CI，1.11, 4,24）；P = 0.02） 。此外，BMF-2-3组表现出中性粒细胞和血小板植入延迟以及移植后B细胞恢复延迟。这些发现证明了 BMF 在移植结果中的重要性，并引起了人们对 BMF AML 的更多关注。© 2024。作者。
Bone marrow fibrosis (BMF) of unknown etiology was common in hematological malignancies, but its prognostic value for acute myeloid leukemia (AML) is unclear. We interrogated data from 532 newly diagnosed subjects with AML receiving allogeneic hematological stem cell transplantation to evaluate the prognostic impact of BMF on transplant outcomes. Using the European consensus on the grading of BMF at diagnosis, 255 (48%) subjects were BMF-0, 209 (39%), BMF-1 and 68 (13%), BMF-2-3. Subjects with BMF-2-3 had poor overall survival (P < 0.001), disease-free survival (P < 0.001) and a higher incidence of relapse (CIR, P < 0.001). Multi-variable analyses in subjects achieving pre-transplant complete remission showed BMF-2-3 was an independent risk factor for CIR (Hazard Ratio [HR] = 2.17, (95% CI, 1.11, 4,24); P = 0.02). Furthermore, BMF-2-3 group showed delayed neutrophil and platelet engraftment and delayed B cell recovery post-transplantation. These findings demonstrate the significance of BMF in transplant outcomes and attract more attention to AML with BMF.© 2024. The Author(s).