Abstract：
Therapy-related myeloid neoplasms (t-MN) are a leading cause of nonrelapse mortality after autologous peripheral blood stem cell transplantation (aPBSCT) in patients with Hodgkin lymphoma (HL) and non-Hodgkin lymphomas (NHL). t-MN patients treated at an earlier stage of disease evolution have a better prognosis, and this presents a need to identify patients at risk for t-MN.
Using a prospective longitudinal study design, this study evaluated peripheral blood parameters pre-aPBSCT and on day 100, at 6 months, 1 year, 2 years, and 3 years in 304 patients treated with aPBSCT. The relation between peripheral blood parameters and subsequent development of t-MN was examined, and nomograms were developed to identify patients at risk for t-MN.
Twenty-one patients developed t-MN at a median of 1.95 years post-aPBSCT. Hemoglobin, hematocrit, white blood cell, and platelet counts were lower among patients who developed t-MN compared to those who did not; these differences appeared soon after aPBSCT, persisted, and preceded development of t-MN. Older age at aPBSCT (hazard ratio [HR]per_year_increase = 1.08, P = .007), exposure to total body irradiation (TBI) (HR = 2.90, P = .04), and low 100-day platelet count (HRincrease_per_unit_decline_in_PLT = 1.01, P = .002) predicted subsequent t-MN. These parameters and primary diagnosis allowed identification of patients at high risk of t-MN (eg, an HL patient undergoing aPBSCT at the age of 70 years with TBI and with a day 100 PLT between 100,000 and 150,000 would have a 62% probability of developing t-MN at 6 years post-aPBSCT).
Abnormalities in peripheral blood parameters can identify patients at high risk for t-MN after aPBSCT for HL or NHL, allowing opportunities to personalize close surveillance and possible disease-modifying interventions.
Using a prospective longitudinal study design, this study evaluated peripheral blood parameters pre-aPBSCT and on day 100, at 6 months, 1 year, 2 years, and 3 years in 304 patients treated with aPBSCT. The relation between peripheral blood parameters and subsequent development of t-MN was examined, and nomograms were developed to identify patients at risk for t-MN.
Twenty-one patients developed t-MN at a median of 1.95 years post-aPBSCT. Hemoglobin, hematocrit, white blood cell, and platelet counts were lower among patients who developed t-MN compared to those who did not; these differences appeared soon after aPBSCT, persisted, and preceded development of t-MN. Older age at aPBSCT (hazard ratio [HR]per_year_increase = 1.08, P = .007), exposure to total body irradiation (TBI) (HR = 2.90, P = .04), and low 100-day platelet count (HRincrease_per_unit_decline_in_PLT = 1.01, P = .002) predicted subsequent t-MN. These parameters and primary diagnosis allowed identification of patients at high risk of t-MN (eg, an HL patient undergoing aPBSCT at the age of 70 years with TBI and with a day 100 PLT between 100,000 and 150,000 would have a 62% probability of developing t-MN at 6 years post-aPBSCT).
Abnormalities in peripheral blood parameters can identify patients at high risk for t-MN after aPBSCT for HL or NHL, allowing opportunities to personalize close surveillance and possible disease-modifying interventions.
摘要：
治疗相关的骨髓性肿瘤（t-MN）是霍奇金淋巴瘤（HL）和非霍奇金淋巴瘤（NHL）患者自体外周血干细胞移植（aPBSCT）后非复发死亡的主要原因。在疾病演变的早期阶段接受治疗的t-MN患者预后较好，这表明需要确定有t-MN风险的患者。
使用前瞻性纵向研究设计，这项研究评估了aPBSCT前和第100天，6个月时的外周血参数，1年,2年,304例接受aPBSCT治疗的患者为3年。检查了外周血参数与随后的t-MN发展之间的关系，并绘制列线图以鉴定有t-MN风险的患者。
21名患者在aPBSCT后1.95年出现t-MN。血红蛋白,血细胞比容,白细胞,与未发生t-MN的患者相比，发生t-MN的患者的血小板计数较低；这些差异在aPBSCT后不久出现，坚持,并先于t-MN的发展。aPBSCT的年龄较大(每年增加的危险比[HR]=1.08，P=.007)，全身照射（TBI）（HR=2.90，P=.04），和低100天血小板计数（HRincrease_per_unit_declines_in_PLT=1.01，P=0.002）预测随后的t-MN。这些参数和初步诊断允许识别t-MN高风险患者(例如，接受aPBSCT的HL患者,年龄为70岁,患有TBI,第100天PLT在100,000至150,000之间,在aPBSCT后6年发生t-MN的概率为62%).
外周血参数异常可以识别HL或NHLaPBSCT后t-MN高危患者，允许个性化密切监测和可能的疾病改善干预措施的机会。
使用前瞻性纵向研究设计，这项研究评估了aPBSCT前和第100天，6个月时的外周血参数，1年,2年,304例接受aPBSCT治疗的患者为3年。检查了外周血参数与随后的t-MN发展之间的关系，并绘制列线图以鉴定有t-MN风险的患者。
21名患者在aPBSCT后1.95年出现t-MN。血红蛋白,血细胞比容,白细胞,与未发生t-MN的患者相比，发生t-MN的患者的血小板计数较低；这些差异在aPBSCT后不久出现，坚持,并先于t-MN的发展。aPBSCT的年龄较大(每年增加的危险比[HR]=1.08，P=.007)，全身照射（TBI）（HR=2.90，P=.04），和低100天血小板计数（HRincrease_per_unit_declines_in_PLT=1.01，P=0.002）预测随后的t-MN。这些参数和初步诊断允许识别t-MN高风险患者(例如，接受aPBSCT的HL患者,年龄为70岁,患有TBI,第100天PLT在100,000至150,000之间,在aPBSCT后6年发生t-MN的概率为62%).
外周血参数异常可以识别HL或NHLaPBSCT后t-MN高危患者，允许个性化密切监测和可能的疾病改善干预措施的机会。
