首页> 外文期刊>Bone marrow transplantation >Presence of CD34(+)CD38(-)CD58(-) leukemia-propagating cells at diagnosis identifies patients at high risk of relapse with Ph chromosome-positive ALL after allo-hematopoietic SCT
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Presence of CD34(+)CD38(-)CD58(-) leukemia-propagating cells at diagnosis identifies patients at high risk of relapse with Ph chromosome-positive ALL after allo-hematopoietic SCT

机译:诊断时存在CD34(+)CD38(-)CD58(-)白血病增殖细胞可确定同种造血SCT后Ph染色体阳性ALL复发的高风险

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Relapse of Ph chromosome-positive ALL (Ph(+)ALL) results from the persistence of leukemia-propagating cells (LPCs). In Ph(+)ALL, a xenograft assay recently determined that LPCs are enriched in the CD34(+)CD38(-)CD58(-) fraction. Therefore, the prognostic significance of LPCs in Ph+ALL subjects after allogeneic hematopoietic SCT (allo-HSCT) was investigated. A total of 80 consecutive adults with Ph+ALL who underwent allo-HSCT were eligible. A multi-parameter flow cytometry analysis examining CD58-FITC/CD10-PE/CD19-APC-Cy7/CD34-PerCP/CD45-Vioblue/CD38-APC on gated leukemia BM blasts was performed at diagnosis. Based on the original blast phenotypes, subjects were stratified into the CD34(+)CD38(-)CD58(-) group (N = 15) and other phenotype group (N = 65). During minimal residual disease monitoring, significantly higher levels of BCR/ABL transcripts were detected in subjects in the CD34(+)CD38(-)CD58(-) group than in other phenotype group, especially at 3 months post HSCT. In addition, CD34(+)CD38(-)CD58(-) LPCs are directly correlated with a higher 3-year cumulative incidence of relapse (CIR) and worse leukemia-free survival (LFS) and OS. Multivariate analyses indicated that presence of CD34(+)CD38(-)CD58(-) LPCs at diagnosis, and BCR-ABL reduction at 3 months post HSCT were independent risk factors for relapse, LFS and OS. Our data suggest that presence of CD34(+)CD38(-)CD58(-) LPCs at diagnosis allows rapid identification of high-risk patients for relapse after allo-HSCT.
机译:Ph染色体阳性ALL(Ph(+)ALL)的复发归因于白血病传播细胞(LPC)的持续存在。在Ph(+)ALL,最近异种移植测定确定LPCs丰富CD34(+)CD38(-)CD58(-)部分。因此,研究了同种异体造血SCT(allo-HSCT)后LPCs在Ph + ALL受试者中的预后意义。总共有80位接受了all-HSCT的Ph + ALL成年人入选。诊断时进行了多参数流式细胞术分析,检查了门控白血病BM细胞的CD58-FITC / CD10-PE / CD19-APC-Cy7 / CD34-PerCP / CD45-Vioblue / CD38-APC。根据原始原始表型,将受试者分为CD34(+)CD38(-)CD58(-)组(N = 15)和其他表型组(N = 65)。在最少的残留疾病监测过程中,CD34(+)CD38(-)CD58(-)组的受试者中检测到的BCR / ABL转录水平明显高于其他表型组,尤其是在HSCT后3个月。此外,CD34(+)CD38(-)CD58(-)LPC与更高的3年累积复发率(CIR)和较差的无白血病生存率(LFS)和OS直接相关。多因素分析表明,诊断时存在CD34(+)CD38(-)CD58(-)LPC,HSCT后3个月BCR-ABL降低是复发,LFS和OS的独立危险因素。我们的数据表明,在诊断时CD34(+)CD38(-)CD58(-)LPC的存在可以快速识别高危患者,然后进行异体HSCT复发。

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