| 1. |
- Gowin, Krisstina, et al.
(författare)
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Survival following allogeneic transplant in patients with myelofibrosis
- 2020
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Ingår i: Blood Advances. - : AMER SOC HEMATOLOGY. - 2473-9529 .- 2473-9537. ; 4:9, s. 1965-1973
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Tidskriftsartikel (refereegranskat)abstract
- Allogeneic hematopoietic cell transplantation (HCT) is the only curative therapy for myelofibrosis (MF). In this large multicenter retrospective study, overall survival (OS) in MF patients treated with allogeneic HCT (551 patients) and without HCT (non-HCT) (1377 patients) was analyzed with Cox proportional hazards model. Survival analysis stratified by the Dynamic International Prognostic Scoring System (DIPSS) revealed that the first year of treatment arm assignment, due to upfront risk of transplant-related mortality (TRM), HCT was associated with inferior OS compared with non-HCT (non-HCT vs HCT: DIPSS intermediate 1 [Int-1]: hazard ratio [HR] = 0.26, P < .0001; DIPSS-Int-2 and higher: HR, 0.39, P < .0001). Similarly, in the DIPSS low-risk MF group, due to upfront TRM risk, OS was superior with non-HCT therapies compared with HCT in the first-year post treatment arm assignment (HR, 0.16, P = .006). However, after 1 year, OS was not significantly different (HR, 1.38, P = .451). Beyond 1 year of treatment arm assignment, an OS advantage with HCT therapy in Int-1 and higher DIPSS score patients was observed (non-HCT vs HCT: DIPSS-Int-1: HR, 2.64, P < .0001; DIPSS-Int-2 and higher: HR, 2.55, P < .0001). In conclusion, long-term OS advantage with HCT was observed for patients with Int-1 or higher risk MF, but at the cost of early TRM. The magnitude of OS benefit with HCT increased as DIPSS risk score increased and became apparent with longer follow-up.
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| 2. |
- Gullberg, U, et al.
(författare)
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Receptors for hematopoietic regulatory cytokines : overview of structure and function
- 1995. - 1
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Ingår i: Cytokines: : Interleukins and Their Receptors - Interleukins and Their Receptors. - Boston, MA : Springer US. - 0927-3042. - 9780792336365 - 9781461312413 ; 80, s. 1-24
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Bokkapitel (refereegranskat)abstract
- The production of blood cells is regulated by the action of external factors, cytokines, that can be released by many cell types. In the first place, a population of multipotent stem cells, mostly in the resting Go phase of the cell cycle, but with self-renewal capacity, gives rise to progenitor cells that are predetermined for differentiation into all kinds of blood cells. Expression of genes for cytokine receptors leads to external regulation of hematopoiesis by cytokines which bind to the receptors, resulting in modifications of proliferation and differentiation, as cytokines are not only growth factors, but are also maturation factors capable of directing hematopoiesis towards functionally competent cells. What is more, they are survival factors capable of suppressing programmed cell death (apoptosis). This is of particular importance for the viability of stem cells which must be preserved. Thus cytokines can act at all positions of the hematopoietic family tree, and the response can differ from proliferation and differentiation of progenitor cells to functional activation of mature cells. Under physiological conditions, during constitutive hematopoiesis, the regulatory cytokines are produced locally, for instance by stromal ceils of the microenvironment, and act locally in a paracrine manner [2].
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