Blood:指导AML患者何时进行造血干细胞移植的一种个体化方法

2020-09-13 MedSci原创 MedSci原创

最近,开发了一种由大数据集指导的多阶段模型(知识库[KB]算法),用于改善AML的预后预测和定制治疗决策,包括造血干细胞移植(HSCT)。

最近,开发了一种由大数据集指导的多阶段模型(知识库[KB]算法),用于改善AML的预后预测和定制治疗决策,包括造血干细胞移植(HSCT)。

在本研究中,研究人员在ALFA-0702试验的656位60岁以下的AML患者中评估了KB指导在第一次完全缓解期(CR1)进行HSCT的表现。

KB对总生存率(OS)的预测优于欧洲白血病网(ELN) 2017年风险分层的预测(C指数 68.9 vs 63.0)。在获得CR1的患者中,HSCT作为一个时间依赖性的协变量,被用于那些ELN2017风险分层较好和NPM1 MRD阴性的患者。采用KB模拟CR1期未进行HSCT的患者的5年生存期(KB评分),研究人员在一项类似的时间依赖分析中发现,在KB评分和HSCT之间存在显著的相互作用,只有在基于KB模拟的预后良好的患者中,CR1期进行HSCT才是有害的(KB评分≥40)。

最后,研究人员将ELN 2017、NPM1 MRD和KB评分整合,将545名CR1期患者分成了278名(51.0%)HSCT候选人和267名(49.0%)单次化疗候选人。在时间依赖性和6个月里程碑分析中,HSCT可显著改善HSCT候选人的OS,虽然它同时可显著缩短单纯化疗候选人的OS。

总而言之,将KB预测与ELN 2017和MRD相结合可能是优化年轻AML患者HSCT时机的一种有效方法。

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    2020-09-17 qinqiyun

    希望应用于临床

    0

  3. 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    2020-09-15 学习

    KB预测与ELN 2017和MRD相结合可能是优化年轻AML患者HSCT时机的一种有效方法,学到了

    0

  4. 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createdTime=Thu Sep 17 23:53:31 CST 2020, time=2020-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=885514, encodeId=0a528855145d, content=KB预测与ELN 2017和MRD相结合可能是优化年轻AML患者HSCT时机的一种有效方法,学到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96c55418190, createdName=学习, createdTime=Tue Sep 15 17:07:31 CST 2020, time=2020-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1025497, encodeId=67ba102549e1d, content=干细胞是热点,但是进入临床仍然需要时间和临床疗效验证哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=独孤立克, createdTime=Wed Sep 16 22:16:41 CST 2020, time=2020-09-16, status=1, ipAttribution=), 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level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4gCIdSaEkahCNuUWZv4iaKmqvUKHyKnBiarBM9RStQKBeV5Lh6GYYFiamdV5KlSfbLvmAgZTLtq81XA/0, createdBy=13511650672, createdName=言西早, createdTime=Mon Sep 14 10:19:13 CST 2020, time=2020-09-14, status=1, ipAttribution=)]
    2020-09-16 独孤立克

    干细胞是热点,但是进入临床仍然需要时间和临床疗效验证哦

    0

  5. 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level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4gCIdSaEkahCNuUWZv4iaKmqvUKHyKnBiarBM9RStQKBeV5Lh6GYYFiamdV5KlSfbLvmAgZTLtq81XA/0, createdBy=13511650672, createdName=言西早, createdTime=Mon Sep 14 10:19:13 CST 2020, time=2020-09-14, status=1, ipAttribution=)]
    2020-09-16 tanxin87878787

    学习,收获

    0

  6. 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    2020-09-16 14818eb4m67暂无昵称

    学习

    0

  7. 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  8. 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  9. 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level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4gCIdSaEkahCNuUWZv4iaKmqvUKHyKnBiarBM9RStQKBeV5Lh6GYYFiamdV5KlSfbLvmAgZTLtq81XA/0, createdBy=13511650672, createdName=言西早, createdTime=Mon Sep 14 10:19:13 CST 2020, time=2020-09-14, status=1, ipAttribution=)]
    2020-09-15 俅侠
  10. 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level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4gCIdSaEkahCNuUWZv4iaKmqvUKHyKnBiarBM9RStQKBeV5Lh6GYYFiamdV5KlSfbLvmAgZTLtq81XA/0, createdBy=13511650672, createdName=言西早, createdTime=Mon Sep 14 10:19:13 CST 2020, time=2020-09-14, status=1, ipAttribution=)]
    2020-09-14 言西早

    将KB预测与ELN 2017和MRD相结合可能是优化年轻AML患者HSCT时机的一种有效方法。

    0

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Lancet oncol:AML移植后采用索拉菲尼维持治疗的疗效和耐受性

索拉非尼维持治疗或可减少FLT3-ITD急性髓系白血病患者异基因造血干细胞移植后的复发。南方医科大刘启发主任率领团队开展了一项3期试验,评估这类患者采用索拉菲尼维持治疗的疗效和安全性。

Blood:端粒长度对造血干细胞移植患者预后的影响

造血干细胞移植是MDS患者的唯一治愈方法,但长期存活情况受到移植相关并发症风险的限制。端粒长度短,由遗传或获得性因素介导,削弱了细胞对遗传毒性和复制性应激的反应,并可鉴定出移植后具有较高毒性风险的患者

Blood:异基因造血干细胞移植后非复发性死亡的预后标志物

目前仍缺乏对儿科年龄组异基因造血干细胞移植(HCT)后非复发性死亡(NRM)的预后生物标志物的评估。为了满足这一需求,研究人员进行了一项前瞻性队列研究(NCT02194439)。招募了415位于2013年-2018年期间进行治疗的患者:170位不超过10岁的儿童和245位10岁以上的个体,包括儿童和成年人。在HCT前和HCT后第7天、14天和21天分别对4个血浆生物标志物(刺激因子-2[ST2]、

2019 JSHCT临床实践建议:异基因造血干细胞移植后人类疱疹病毒6B脑炎的诊断和管理

2019年11月,日本造血干细胞移植学会(JSHCT)发布了异基因造血干细胞移植后人类疱疹病毒6B脑炎的诊断和管理建议,人类疱疹病毒(HHV)-6B在激活在异基因造血干细胞移植后比较常见,HHV-6B疾病可能因此而发展,其中HHV-6B是一种严重致命的并发症。本文主要针对异基因造血干细胞移植后人类疱疹病毒6B脑炎的诊断和管理提供指导建议。