Abstract：
Few studies have addressed the role of reduced-intensity conditioning (RIC) and non-myeloablative (NMA) regimens in older adults with Philadelphia acute lymphoblastic leukemia (Ph + ALL). The objective of this current study was to compare the outcomes of RIC/NMA versus TBI-based myeloablative (MAC) regimens in Ph + ALL patients older than 40 years old who underwent hematopoietic cell transplantation (HCT) in CR1. We used a freely available database from the CIBMTR. Transplants were performed between 2013 and 2017. With a median follow-up of 37.6 months, we have included 629 patients. We used propensity score weighting. Three-year OSs were 64% in the TBI-MAC group and 66% in the RIC/NMA group. OS was not different (HR = 0.92; p = 0.69). Three-year relapse incidences were 21.6% and 27.6% in the TBI-MAC and RIC/NMA groups. RIC/NMA was not associated with an increase in relapse rate (HR 1.02; p = 0.91). Three-year NRMs were 24.3% in the TBI-MAC group and 20.3% in the RIC/NMA group. RIC/NMA was not associated with superior NRM (HR 0.88; p = 0.57). In summary, we have shown that RIC/NMA regimens achieve outcomes comparable to TBI-based MAC in Ph+ ALL older patients in CR1 who may tolerate a TBI-based MAC regimen.
摘要：
很少有研究探讨低强度调理（RIC）和非清髓性（NMA）方案在费城急性淋巴细胞白血病（PhALL）老年人中的作用。本研究的目的是比较RIC/NMA与基于TBI的清髓性（MAC）方案在CR1中接受造血细胞移植（HCT）的40岁以上PhALL患者中的结果。我们使用了来自CIBMTR的免费数据库。移植在2013年至2017年之间进行。中位随访时间为37.6个月，我们纳入了629名患者。我们使用倾向得分加权。三年OS在TBI-MAC组中为64%,在RIC/NMA组中为66%。OS没有差异(HR=0.92;p=0.69)。TBI-MAC和RIC/NMA组的三年复发率分别为21.6%和27.6%。RIC/NMA与复发率的增加无关（HR1.02；p=0.91）。TBI-MAC组的三年NRM为24.3％，RIC/NMA组为20.3％。RIC/NMA与优越的NRM无关（HR0.88；p=0.57）。总之,我们已经表明,RIC/NMA方案在CR1的Ph+所有可能耐受基于TBI的MAC方案的老年患者中取得了与基于TBI的MAC相当的结局.
