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【Blood】WHO分类和WPSS预测myelodysplastic syndrome患者
WHO classification and WPSS predict posttransplantation outcome in patients with myelodysplastic syndrome: a study from the Gruppo Italiano Trapianto di Midollo Osseo (GITMO)
We evaluated the impact of World Health Organization (WHO) classification and WHO classification–based Prognostic Scoring System (WPSS) on the outcome of patients with myelodysplastic syndrome (MDS) who underwent allogeneic stem cell transplantation (allo-SCT) between 1990 and 2006. Five-year overall survival (OS) was 80% in refractory anemias, 57% in refractory cytopenias, 51% in refractory anemia with excess blasts 1 (RAEB-1), 28% in RAEB-2, and 25% in acute leukemia from MDS (P = .001). Five-year probability of relapse was 9%, 22%, 24%, 56%, and 53%, respectively (P < .001). Five-year transplant-related mortality (TRM) was 14%, 39%, 38%, 34%, and 44%, respectively (P = .24). In multivariate analysis, WHO classification showed a significant effect on OS (P = .017) and probability of relapse (P = .01); transfusion dependency was associated with a reduced OS (P = .01) and increased TRM (P = .037), whereas WPSS showed a prognostic significance on both OS (P = .001) and probability of relapse (P < .001). In patients without excess blasts, multilineage dysplasia and transfusion dependency affected OS (P = .001 and P = .009, respectively), and were associated with an increased TRM (P = .013 and P = .031, respectively). In these patients, WPSS identified 2 groups with different OS and TRM. These data suggest that WHO classification and WPSS have a relevant prognostic value in posttransplantation outcome of MDS patients. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 We evaluated the impact of World Health Organization (WHO) classification and WHO classification–based Prognostic Scoring System (WPSS) on the outcome of patients with myelodysplastic syndrome (MDS) who underwent allogeneic stem cell transplantation (allo-SCT) between 1990 and 2006.本文评价了世界卫生组织分类（WHO）及基于WHO分类的预后评分系统（WPSS）对1990-2006年接受异基因干细胞移植的骨髓增生异常综合征患者临床后果的影响。 Five-year overall survival (OS) was 80% in refractory anemias, 57% in refractory cytopenias, 51% in refractory anemia with excess blasts 1 (RAEB-1), 28% in RAEB-2, and 25% in acute leukemia from MDS (P = .001). 难治性贫血患者的五年总体生存率（OS）为80%，难治性血细胞减少为57%，难治性贫血伴原始细胞增多-1（RAEB-1）为51%，RAEB-2为28%，MDS转化的急性白血病为25%。Five-year probability of relapse was 9%, 22%, 24%, 56%, and 53%, respectively (P < .001).五年复发率分别为9%、22%、24%、56%和53%（P﹤0.001）。 Five-year transplant-related mortality (TRM) was 14%, 39%, 38%, 34%, and 44%, respectively (P = .24). 五年移植相关死亡率分别为14%、39%、38%、34%和44%（P=0.24）。In multivariate analysis, WHO classification showed a significant effect on OS (P = .017) and probability of relapse (P = .01); transfusion dependency was associated with a reduced OS (P = .01) and increased TRM (P = .037), whereas WPSS showed a prognostic significance on both OS (P = .001) and probability of relapse (P < .001). 多因素分析显示，WHO分类对OS有显著影响（P=0.01）；依赖输血治疗与OS下降（P=0.01）及TRM升高（P=0.001）有关；而WPSS对OS（P=0.001）和复发率（P﹤0.001）均有显著影响。In patients without excess blasts, multilineage dysplasia and transfusion dependency affected OS (P = .001 and P = .009, respectively), and were associated with an increased TRM (P = .013 and P = .031, respectively).多系发育异常和依赖输血治疗对不伴有原始细胞增多的MDS患者的OS有影响（P值分别为0.001和0.009），并与TRM升高有关（P值分别为0.013和0.031）。 In these patients, WPSS identified 2 groups with different OS and TRM.在这类病人中WPSS确定了OS和TRM不同的两个组。 These data suggest that WHO classification and WPSS have a relevant prognostic value in posttransplantation outcome of MDS patients.研究数据表明WHO分类和WPSS对于MDS患者移植后临床后果的预后评估有一定价值。
编译如下：
本文评价了世界卫生组织分类（WHO）及基于WHO分类的预后评分系统（WPSS）对1990-2006年接受异基因干细胞移植的骨髓增生异常综合征患者临床后果的影响。难治性贫血患者的五年总体生存率（OS）为80%，难治性血细胞减少为57%，难治性贫血伴原始细胞增多-1（RAEB-1）为51%，RAEB-2为28%，MDS转化的急性白血病为25%。五年复发率分别为9%、22%、24%、56%和53%（P﹤0.001）。五年移植相关死亡率分别为14%、39%、38%、34%和44%（P=0.24）。多因素分析显示，WHO分类对OS有显著影响（P=0.01）；依赖输血治疗与OS下降（P=0.01）及TRM升高（P=0.001）有关；而WPSS对OS（P=0.001）和复发率（P﹤0.001）均有显著影响。多系发育异常和依赖输血治疗对不伴有原始细胞增多的MDS患者的OS有影响（P值分别为0.001和0.009），并与TRM升高有关（P值分别为0.013和0.031）。在这类病人中WPSS确定了OS和TRM不同的两个组。研究数据表明WHO分类和WPSS对于MDS患者移植后临床后果的预后评估有一定价值。 [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-06-03 17:14
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