دورية أكاديمية
Allogeneic Hematopoietic Stem Cell Transplantation for Chronic Myelomonocytic Leukemia:Clinical and Molecular Genetic Prognostic Factors in a Nordic Population
| العنوان: | Allogeneic Hematopoietic Stem Cell Transplantation for Chronic Myelomonocytic Leukemia:Clinical and Molecular Genetic Prognostic Factors in a Nordic Population |
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| المؤلفون: | Wedge, Eileen, Hansen, Jakob Werner, Dybedal, Ingunn, Creignou, Maria, Ejerblad, Elisabeth, Lorenz, Fryderyk, Werlenius, Olle, Ungerstedt, Johanna, Holm, Mette Skov, Nilsson, Lars, Kittang, Astrid Olsnes, Antunovic, Peter, Rohon, Peter, Andersen, Mette Klarskov, Papaemmanuil, Elli, Bernard, Elsa, Jädersten, Martin, Hellström-Lindberg, Eva, Grønbæk, Kirsten, Ljungman, Per, Friis, Lone Smidstrup |
| المصدر: | Wedge , E , Hansen , J W , Dybedal , I , Creignou , M , Ejerblad , E , Lorenz , F , Werlenius , O , Ungerstedt , J , Holm , M S , Nilsson , L , Kittang , A O , Antunovic , P , Rohon , P , Andersen , M K , Papaemmanuil , E , Bernard , E , Jädersten , M , Hellström-Lindberg , E , Grønbæk , K , Ljungman , P & Friis , L S 2021 , ' Allogeneic Hematopoietic Stem Cell Transplantation for Chronic Myelomonocytic .... |
| سنة النشر: | 2021 |
| المجموعة: | Aarhus University: Research |
| مصطلحات موضوعية: | Chronic myelomonocytic leukemia, Hematopoietic stem cell transplantation, High-throughput nucleotide sequencing, Mutations, Risk factors |
| الوصف: | Chronic myelomonocytic leukemia (CMML) is an aggressive disease in which survival after allogeneic hematopoietic stem cell transplantation (HCT) remains relatively poor. An assessment of prognostic factors is an important part of treatment decision making and has the potential to be greatly improved by the inclusion of molecular genetics. However, there is a significant knowledge gap in the interpretation of mutational patterns. This study aimed to describe outcomes of allogeneic HCT in patients with CMML in relation to clinical and molecular genetic risk factors. This retrospective study included 64 patients with CMML who underwent allogeneic HCT between 2008 and 2018, with a median follow-up of 5.4 years. Next-generation sequencing using targeted myeloid panels was carried out on saved material from 51 patients from the time of transplantation. Kaplan-Meier and Cox regression were used for analysis of overall survival (OS), and cumulative incidence with competing risks and Fine and Gray models were used for analysis of relapse and nonrelapse mortality (NRM). Mutations were detected in 48 patients (94%), indicating high levels of minimal residual disease (MRD) positivity at transplantation, even among those in complete remission (CR) (n = 14), 86% of whom had detectable mutations. The most frequently mutated genes were ASXL1 (37%), TET2 (37%), RUNX1 (33%), SRSF2 (26%), and NRAS (20%). Risk stratification using the CMML-specific Prognostic Scoring System molecular score (CPSS-Mol) resulted in 45% of patients moving to a higher risk-group compared with risk stratification using the CPSS. High leucocyte count (≥13 × 10 9 /L), transfusion requirement, and previous intensive chemotherapy were associated with higher incidence of relapse. Being in CR was not linked to better outcomes. Neither ASXL1 nor RUNX1 mutation was associated with a difference in OS, relapse, or NRM, despite being high risk in the nontransplantation setting. TET2 mutations were associated with a significantly higher 3-year OS (73% versus 40%; P ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | https://pure.au.dk/portal/da/publications/allogeneic-hematopoietic-stem-cell-transplantation-for-chronic-myelomonocytic-leukemiaTest(b7a117f6-22cb-4efb-a48a-cbdd3ceeca4f).html |
| DOI: | 10.1016/j.jtct.2021.08.028 |
| الإتاحة: | https://doi.org/10.1016/j.jtct.2021.08.028Test https://pure.au.dk/portal/da/publications/allogeneic-hematopoietic-stem-cell-transplantation-for-chronic-myelomonocytic-leukemiaTest(b7a117f6-22cb-4efb-a48a-cbdd3ceeca4f).html http://www.scopus.com/inward/record.url?scp=85118151967&partnerID=8YFLogxKTest |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.272EC525 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.jtct.2021.08.028 |
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