目的:对3个血液学中心的成人早期前体T细胞白血病/淋巴瘤(ETP-ALL/LBL)患者进行回顾性分析,总结其临床特点、治疗及预后影响因素。方法:收集2006年1月至2019年1月来自北京大学第三医院、解放军第一医学中心和中国医学科学院血液学研究所...目的:对3个血液学中心的成人早期前体T细胞白血病/淋巴瘤(ETP-ALL/LBL)患者进行回顾性分析,总结其临床特点、治疗及预后影响因素。方法:收集2006年1月至2019年1月来自北京大学第三医院、解放军第一医学中心和中国医学科学院血液学研究所3个血液研究中心共113例T淋巴母细胞白血病/淋巴瘤(T-ALL/LBL)患者的临床数据资料,对其中ETP-ALL/LBL及非ETP-ALL/LBL患者的临床特征及预后进行分析比较。结果:113例T-ALL/LBL患者中,13例诊断为ETP-ALL/LBL(11.5%),其中男性患者11例(84.6%),中位年龄28(18-53)岁。与非ETP-ALL/LBL患者相比,ETP-ALL/LBL患者在年龄、性别、纵隔大包块发生率、临床分期、IPI评分、白细胞水平、乳酸脱氢酶水平方面差异无统计学意义。在13例ETP-ALL/LBL患者中,9例(69.2%)获得完全缓解,ETP-ALL/LBL患者较非ETP-ALL/LBL患者化疗诱导缓解率无统计学差异。在单纯化疗未进行异基因造血干细胞移植的患者中,ETP-ALL/LBL组较非ETP-ALL/LBL组显示出更差的5年生存率(0 vs 7.1%,P=0.008),而在进行异基因造血干细胞移植的患者中,两组5年生存率无统计学差异(37.5%vs 40.2%,P>0.05)。多因素Cox回归分析提示,诱导治疗达到完全缓解、异基因造血干细胞移植以及乳酸脱氢酶水平为影响T-ALL/LBL的独立预后因素。结论:ETP-ALL/LBL较其他类型T-ALL/LBL患者诱导化疗反应率无显著差异,诱导缓解后续贯异基因造血干细胞移植巩固治疗对于提高ETP-ALL/LBL患者远期生存率具有重要意义。展开更多
Background:Secondary acute lymphoblastic leukemia(sALL)is rare in patients diagnosed with antecedent multiple myeloma(MM).This study aimed to elucidate the clinical features and outcomes of patients with sALL after MM...Background:Secondary acute lymphoblastic leukemia(sALL)is rare in patients diagnosed with antecedent multiple myeloma(MM).This study aimed to elucidate the clinical features and outcomes of patients with sALL after MM.Methods:We conducted this population-based study using the Surveillance,Epidemiology,and End Results(SEER)database and retrospectively reviewed patients with sALL following MM treatment at our institution.Cox regression analysis was performed to investigate the prognostic factors for survival in patients with sALL.Results:We identified 64,629 cases of MM(including 18 sALL from the SEER Plus 9 database,and three sALL from our institution).Younger patients with MM and those who received chemotherapy were at a higher risk of developing sALL.The novel agent era witnessed an increased incidence of sALL(post-novel agent era vs.pre-novel agent era:0.31%[10/32,640]vs.0.25%[8/31,989])and shorter latency time(post-novel agent era vs.pre-novel agent era[median]:51.5 vs.74.5 months,P=0.516),though the difference was not significant.The median age at sALL onset was 65(range:47-78)years.Significant cytopenia and absence of BCR/ABL fusion genes were common features in this patient population.The treatment of sALL is complicated by old age and poor performance status.The median survival of patients with sALL is 18 months,whereas those who received chemotherapy had significantlyprolonged survival Conclusions:Patients with sALL combined with an antecedent MM,especially those with long-term exposure to immunomodulatory agents such as thalidomide or lenalidomide,should be cautiously evaluated and managed with a comprehensive approach.展开更多
文摘目的:对3个血液学中心的成人早期前体T细胞白血病/淋巴瘤(ETP-ALL/LBL)患者进行回顾性分析,总结其临床特点、治疗及预后影响因素。方法:收集2006年1月至2019年1月来自北京大学第三医院、解放军第一医学中心和中国医学科学院血液学研究所3个血液研究中心共113例T淋巴母细胞白血病/淋巴瘤(T-ALL/LBL)患者的临床数据资料,对其中ETP-ALL/LBL及非ETP-ALL/LBL患者的临床特征及预后进行分析比较。结果:113例T-ALL/LBL患者中,13例诊断为ETP-ALL/LBL(11.5%),其中男性患者11例(84.6%),中位年龄28(18-53)岁。与非ETP-ALL/LBL患者相比,ETP-ALL/LBL患者在年龄、性别、纵隔大包块发生率、临床分期、IPI评分、白细胞水平、乳酸脱氢酶水平方面差异无统计学意义。在13例ETP-ALL/LBL患者中,9例(69.2%)获得完全缓解,ETP-ALL/LBL患者较非ETP-ALL/LBL患者化疗诱导缓解率无统计学差异。在单纯化疗未进行异基因造血干细胞移植的患者中,ETP-ALL/LBL组较非ETP-ALL/LBL组显示出更差的5年生存率(0 vs 7.1%,P=0.008),而在进行异基因造血干细胞移植的患者中,两组5年生存率无统计学差异(37.5%vs 40.2%,P>0.05)。多因素Cox回归分析提示,诱导治疗达到完全缓解、异基因造血干细胞移植以及乳酸脱氢酶水平为影响T-ALL/LBL的独立预后因素。结论:ETP-ALL/LBL较其他类型T-ALL/LBL患者诱导化疗反应率无显著差异,诱导缓解后续贯异基因造血干细胞移植巩固治疗对于提高ETP-ALL/LBL患者远期生存率具有重要意义。
文摘Background:Secondary acute lymphoblastic leukemia(sALL)is rare in patients diagnosed with antecedent multiple myeloma(MM).This study aimed to elucidate the clinical features and outcomes of patients with sALL after MM.Methods:We conducted this population-based study using the Surveillance,Epidemiology,and End Results(SEER)database and retrospectively reviewed patients with sALL following MM treatment at our institution.Cox regression analysis was performed to investigate the prognostic factors for survival in patients with sALL.Results:We identified 64,629 cases of MM(including 18 sALL from the SEER Plus 9 database,and three sALL from our institution).Younger patients with MM and those who received chemotherapy were at a higher risk of developing sALL.The novel agent era witnessed an increased incidence of sALL(post-novel agent era vs.pre-novel agent era:0.31%[10/32,640]vs.0.25%[8/31,989])and shorter latency time(post-novel agent era vs.pre-novel agent era[median]:51.5 vs.74.5 months,P=0.516),though the difference was not significant.The median age at sALL onset was 65(range:47-78)years.Significant cytopenia and absence of BCR/ABL fusion genes were common features in this patient population.The treatment of sALL is complicated by old age and poor performance status.The median survival of patients with sALL is 18 months,whereas those who received chemotherapy had significantlyprolonged survival Conclusions:Patients with sALL combined with an antecedent MM,especially those with long-term exposure to immunomodulatory agents such as thalidomide or lenalidomide,should be cautiously evaluated and managed with a comprehensive approach.
