Sökning: onr:"swepub:oai:DiVA.org:uu-463425" > Allogeneic Hematopo...
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000 | 08535naa a2200697 4500 | |
001 | oai:DiVA.org:uu-463425 | |
003 | SwePub | |
008 | 220110s2021 | |||||||||||000 ||eng| | |
009 | oai:DiVA.org:liu-182031 | |
009 | oai:prod.swepub.kib.ki.se:148418470 | |
024 | 7 | a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4634252 URI |
024 | 7 | a https://doi.org/10.1016/j.jtct.2021.08.0282 DOI |
024 | 7 | a https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-1820312 URI |
024 | 7 | a http://kipublications.ki.se/Default.aspx?queryparsed=id:1484184702 URI |
040 | a (SwePub)uud (SwePub)liud (SwePub)ki | |
041 | a engb eng | |
042 | 9 SwePub | |
072 | 7 | a ref2 swepub-contenttype |
072 | 7 | a art2 swepub-publicationtype |
100 | 1 | a Wedge, Eileenu Copenhagen Univ Hosp, Dept Hematol, Juliane Maries Vej 6, DK-2100 Copenhagen, Denmark.;Univ Copenhagen, Fac Hlth & Med Sci, Biotech Res & Innovat Ctr, Copenhagen, Denmark.;Univ Copenhagen, Danish Stem Cell Ctr Danstem, Copenhagen, Denmark.4 aut |
245 | 1 0 | a Allogeneic Hematopoietic Stem Cell Transplantation for Chronic Myelomonocytic Leukemia :b Clinical and Molecular Genetic Prognostic Factors in a Nordic Population |
264 | 1 | b Elsevier,c 2021 |
338 | a print2 rdacarrier | |
500 | a Funding Agencies|Rigshopitalets Research Foundation; University of Copenhagen; Greater Copenhagen Health Science Partners (Clinical Academic Group in Translational Hematology); Danish Cancer Society (Danish Research Center for Precision Medicine in Blood Cancer) [223-A13071-18-S68]; Novo Nordisk Foundation (Novo Nordisk Foundation Center for Stem Cell Biology, DanStem) [NNF17CC0027852]; Swedish Cancer SocietySwedish Cancer Society [19 0200 Pj]; Stockholm County CouncilStockholm County Council [20190150]; Region Stockholm | |
520 | a Chronic myelomonocytic leukemia (CMML) is an aggressive disease in which survival after allogeneic hematopoietic stem cell transplantation (HCT) remains relatively poor. An assessment of prognostic factors is an important part of treatment decision making and has the potential to be greatly improved by the inclusion of molecular genetics. However, there is a significant knowledge gap in the interpretation of mutational patterns. This study aimed to describe outcomes of allogeneic HCT in patients with CMML in relation to clinical and molecular genetic risk factors. This retrospective study included 64 patients with CMML who underwent allogeneic HCT between 2008 and 2018, with a median follow-up of 5.4 years. Next-generation sequencing using targeted myeloid panels was carried out on saved material from 51 patients from the time of transplantation. Kaplan-Meier and Cox regression were used for analysis of overall survival (OS), and cumulative incidence with competing risks and Fine and Gray models were used for analysis of relapse and nonrelapse mortality (NRM). Mutations were detected in 48 patients (94%), indicating high levels of minimal residual disease (MRD) positivity at transplantation, even among those in complete remission (CR) (n = 14), 86% of whom had detectable mutations. The most frequently mutated genes were ASXL1 (37%), TET2 (37%), RUNX1 (33%), SRSF2 (26%), and NRAS (20%). Risk stratification using the CMML-specific Prognostic Scoring System molecular score (CPSS-Mol) resulted in 45% of patients moving to a higher risk-group compared with risk stratification using the CPSS. High leucocyte count (>= 13 x 10(9)/L), transfusion requirement, and previous intensive chemotherapy were associated with higher incidence of relapse. Being in CR was not linked to better outcomes. Neither ASXL1 nor RUNX1 mutation was associated with a difference in OS, relapse, or NRM, despite being high risk in the nontransplantation setting. TET2 mutations were associated with a significantly higher 3-year OS (73% versus 40%; P =.039). Achieving MRD-negative CR was rare in this CMML cohort, which may explain why we did not observe better outcomes for those in CR. This merits further investigation. Our analyses suggest that the negative impact of ASXL1 and RUNX1 mutations can be overcome by allogeneic HCT; however, risk stratification is complex in CMML and requires larger cohorts and multivariate models, presenting an ongoing challenge in this rare disease. | |
650 | 7 | a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Hematologi0 (SwePub)302022 hsv//swe |
650 | 7 | a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Hematology0 (SwePub)302022 hsv//eng |
650 | 7 | a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Cancer och onkologi0 (SwePub)302032 hsv//swe |
650 | 7 | a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cancer and Oncology0 (SwePub)302032 hsv//eng |
653 | a Chronic myelomonocytic leukemia | |
653 | a Hematopoietic stem cell transplantation | |
653 | a Risk factors | |
653 | a High-throughput nucleotide sequencing | |
653 | a Mutations | |
700 | 1 | a Hansen, Jakob Werneru Copenhagen Univ Hosp, Dept Hematol, Juliane Maries Vej 6, DK-2100 Copenhagen, Denmark.;Univ Copenhagen, Fac Hlth & Med Sci, Biotech Res & Innovat Ctr, Copenhagen, Denmark.;Univ Copenhagen, Danish Stem Cell Ctr Danstem, Copenhagen, Denmark.4 aut |
700 | 1 | a Dybedal, Ingunnu Oslo Univ Hosp, Dept Hematol, Oslo, Norway.4 aut |
700 | 1 | a Creignou, Mariau Karolinska Inst, Ctr Hematol & Regenerat Med, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Hematol, Stockholm, Sweden.4 aut |
700 | 1 | a Ejerblad, Elisabethu Karolinska Institutet,Uppsala universitet,Hematologi,Uppsala Univ Hosp, Sweden4 aut0 (Swepub:uu)eleje020 |
700 | 1 | a Lorenz, Fryderyku Univ Hosp Umeå, Dept Med, Umeå, Sweden.4 aut |
700 | 1 | a Werlenius, Olleu Sahlgrens Univ Hosp, Sect Hematol & Coagulat, Gothenburg, Sweden.4 aut |
700 | 1 | a Ungerstedt, Johannau Karolinska Institutet4 aut |
700 | 1 | a Holm, Mette Skovu Aarhus Univ Hosp, Dept Hematol, Aarhus, Denmark.4 aut |
700 | 1 | a Nilsson, Larsu Skane Univ Hosp, Dept Med, Lund, Sweden.4 aut |
700 | 1 | a Kittang, Astrid Olsnesu Haukeland Hosp, Dept Med, Sect Hematol, Bergen, Norway.4 aut |
700 | 1 | a Antunovic, Petaru Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Hematologiska kliniken US,Linköping Univ Hosp, Dept Hematol, Linköping, Sweden.4 aut0 (Swepub:liu)petan27 |
700 | 1 | a Rohon, Peteru Univ Hosp Olomouc, Dept Hematooncol, Olomouc, Czech Republic.4 aut |
700 | 1 | a Andersen, Mette Klarskovu Karolinska Institutet4 aut |
700 | 1 | a Papaemmanuil, Elliu Mem Sloan Kettering Canc Ctr, Computat Oncol Serv, 1275 York Ave, New York, NY 10021 USA.;Mem Sloan Kettering Canc Ctr, Ctr Hematol Malignancies, 1275 York Ave, New York, NY 10021 USA.4 aut |
700 | 1 | a Bernard, Elsau Mem Sloan Kettering Canc Ctr, Computat Oncol Serv, 1275 York Ave, New York, NY 10021 USA.;Mem Sloan Kettering Canc Ctr, Ctr Hematol Malignancies, 1275 York Ave, New York, NY 10021 USA.4 aut |
700 | 1 | a Jädersten, Martinu Karolinska Inst, Ctr Hematol & Regenerat Med, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Hematol, Stockholm, Sweden.4 aut |
700 | 1 | a Hellström-Lindberg, Evau Karolinska Inst, Ctr Hematol & Regenerat Med, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Hematol, Stockholm, Sweden.4 aut |
700 | 1 | a Gronbaek, Kirstenu Copenhagen Univ Hosp, Dept Hematol, Juliane Maries Vej 6, DK-2100 Copenhagen, Denmark.;Univ Copenhagen, Fac Hlth & Med Sci, Biotech Res & Innovat Ctr, Copenhagen, Denmark.;Univ Copenhagen, Danish Stem Cell Ctr Danstem, Copenhagen, Denmark.4 aut |
700 | 1 | a Ljungman, Peru Karolinska Institutet4 aut |
700 | 1 | a Friis, Lone Smidstrupu Copenhagen Univ Hosp, Dept Hematol, Juliane Maries Vej 6, DK-2100 Copenhagen, Denmark.4 aut |
710 | 2 | a Copenhagen Univ Hosp, Dept Hematol, Juliane Maries Vej 6, DK-2100 Copenhagen, Denmark.;Univ Copenhagen, Fac Hlth & Med Sci, Biotech Res & Innovat Ctr, Copenhagen, Denmark.;Univ Copenhagen, Danish Stem Cell Ctr Danstem, Copenhagen, Denmark.b Oslo Univ Hosp, Dept Hematol, Oslo, Norway.4 org |
773 | 0 | t Transplantation and Cellular Therapyd : Elsevierg 27:12, s. 991.e1-991.e9q 27:12<991.e1-991.e9x 2666-6375x 2666-6367 |
856 | 4 | u https://doi.org/10.1016/j.jtct.2021.08.028 |
856 | 4 8 | u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-463425 |
856 | 4 8 | u https://doi.org/10.1016/j.jtct.2021.08.028 |
856 | 4 8 | u https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-182031 |
856 | 4 8 | u http://kipublications.ki.se/Default.aspx?queryparsed=id:148418470 |
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