Stem cell transplant in MF it’s time to personalize Francesco Passamonti.pdf

该【Stem cell transplant in MF it’s time to personalize Francesco Passamonti 】是由【宝钗文档】上传分享，文档一共【4】页，该文档可以免费在线阅读，需要了解更多关于【Stem cell transplant in MF it’s time to personalize Francesco Passamonti 】的内容，可以使用淘豆网的站内搜索功能，选择自己适合的文档，以下文字是截取该文章内的部分文字，如需要获得完整电子版，请下载此文档到您的设备，方便您编辑和打印。FromestonMay23,?ict-of-interestdisclosure:,(SMF),suchaspost-areinventorsofseveralasparaginase-relatedBCR-ABLpositiveacutelymphoblasticleuke-;100(3):295-.,aspin-,HungerSP,BoosJ,-asparaginasetreatmentinacutelympho-TheMTSSwillimplementcurrentriskblasticleukemia:afocusonErwiniaaspar-?;117(2):238-(seegure)withtheaimofim-,PanYX,ZhouM,HarveyRC,HungerSP,patientssuitableforSCT(age,70years).,KangS,WangX,-asparaginaseresistanceinALLsensitivityandasparaginesynthetaseproteinSomemodelsincludeonlyclinicalbydownregulatingthecalpain-1-Bid-content,butnotmRNA,inacutelymphoblasticvariables;othermodelsincludeclinicalcaspase-3/;133(20):;andmolecular,andothersarebased2222-(2):274-,WaandersE,McLeodJ,,SongX,TangJ,-associatednoanalyzablemetaphases,andaboutDe?ningfunctionalheterogeneityinacuteprotein1:[abstract].;two-;29(5):1881-(21).,7,8makingkaryotype-,,GerasimenkoJV,TsugorkaT,--;62(1):61-:asparaginase-inducedpan-mentatthetimeofdiagnosisofMF(seecreatitiselicitedviaprotease-activatedreceptor?,hiMG,ParasoleR,;gure),accordingtotheMFtype:PMForChildhoodhigh-riskacutelymphoblastic371(1700):,patientsevaluatedby?leukemiainrstremission:essedusingtheMIPSS-;123(10):-2019-03-,ifNGSisnotavailable,1470-1478.?,atleastASXL1mutationTRANSPLANTATIONinintermediate-1DIPSS-,al,page2233theMYSEC-mendedbe-causeitwasspeci?callydevelopedinStemcelltransplantinMF:,thosewithamedianexpectationoflife,5yearsare’potentialcandidatesforSCT,according-FrancescoPassamonti|-intermediate-1/intermediate-2/Blood1Inthisissueof,aldescribeanintegratedclinical-mo-high-riskDIPSS,high-riskMIPSS-70,andlecularprognosticmodel(Myelo?brosisTransplantScoringSystem[MTSS])tointermediate-2/high-riskMYSEC-PMpatientsepoststemcelltransplant(SCT)inmyelo?brosis(MF).MFis(see?gure).aclonalstemcellneoplasmwithheterogeneousclinicalphenotypesandwell-de?neddrivermutationsfoundin～90%,-andintermediate-riskMTSShasaintroductionofJAKinhibitors,3MFstillremainsanincurablediseasewithclearindicationforSCT,asthe5-,but,of90%and77%,respectively,issuperiorbecauseoftheveryhighriskofmortality,thepatientselectionisverytoothertherapies,andthisresultbal-(NRM)of10%to22%.ThefollowingcasesAnext-generationsequencing(NGS)–50%forhighrisk,and34%forveryillustratethedif?cultiesinthemanage-based18--riskandvery-high---:A68-year-oldmanwithposttrainingcohortandmyeloablativeinthewas62%,higherthanthe47%reportedpolycythemiavera–MF(intermediate--PM).Theprojectedlifeex-etal5fromtheEuropeanBoneMarrowthemodelareage$57years,(MYSEC-PM);,90%,plateletcounthence,-studyreportedheremaybeimpactedever,hisMTSScategoryishighrisk,,1503109/L,,bythe9%ofpatientstransplantedwithresultingina5-yearmediansurvivalofHLA-mismatchedunrelateddonor,pres-low-riskdisease,whowouldcurrently50%andatransplantrelatedmortalityenceoftheASXL1mutation,andanon--(TRM)of36%.Inthiscase,survivalis?CALR/MPLgenotype(seegure).Theever,low-riskpatientshavebeenin-equivalentwithstandardtherapyorresulting5-yearoverallsurvival(OS),-90%forlowrisk,77%forintermediaterisk,modelisapplicableinprimaryMF(PMF),2118blood?16MAY2019|VOLUME133,NUMBER20FromestonMay23,<70yearsPMFSMFNGSNOTavailableNGSavailableMYSEC-PMmodelDIPSSmodelMIPSS-70modelASXL1ifint-1PMF-shortterm(<5years)survivorsSMF-shortterm(<5years)survivorsIntermediate-2/HighriskHighriskASXL1-posIntermediate-1Intermediate-2/HighriskApplytoselectedpatientstheMTSSanddiscusssurvivalexpectedandrateofmortalityafterSCTwithpatientsLowriskIntermediateriskHighriskVeryhighrisk5-yearsOS/TRM:90%/10%5-yearsOS/TRM:77%/22%5-yearsOS/TRM:50%/36%5-yearsOS/TRM:34%/57%DecisionGoGoSlowgoNoonSCTAgeHb,g/dLPLT,x109/LWBC,x109/LBlast,%>65(1)<10(2)->25(1)≥1%(1).(1)----MIPSS-70-<10(1)<100(2)>25(2)≥2(1).(1)≥2(1)NonCALRT1(1)HMR(1)/>2(2)-MYSEC-Cont()<11(2)<150(1)--≥3(2).(1)NonCALR(2)--PMMTSS>57(1)-<150(1)>25(1)-K.<90%(1)-Non-CALR/MPL(2)ASXL1(1)MMU(2)CriticalinformationtopersonalizemanagementofpatientswithMF.(Top)Decision?owchartforeachpatientwithMFsuitableforSCT.(Bottom)(DIPSS)categories:low(0);intermediate-1(1-2),intermediate-2(3-4),highrisk(5-6);Mutation-EnhancedInternationalPrognosticScoreSystem(MIPSS-70)categories:low(0-1);intermediate(2-4),highrisk($5);Myelo?brosisSecondaryPrognosticmodel(MYSEC-PM)categories:low(,11);intermediate-1(11-13),intermediate-2(14-15),highrisk($16),;MTSScategories:low(0-2);intermediate(3-4),high(5),very-highrisk(6-9).BM,bonemarrow;BMF,bonemarrow?brosis;Cont,continuous;.,constitutionalsymptoms;Hb,hemoglobinvalue;HMR,high-molecularrisk;K.,Karnofsky;MMU,mismatchedunrelated;mut.,mutation;PLT,plateletcount;.,performancestatus;WBC,(,,MoraB,Maf?-60years),icsinthediagnosisandtreatmentofmyeloproliferativeneo-toproceedtoSCTastheonlytherapy,NGSor,atleast,;23(2):-risk137-:A60-year-oldwomanwithprocedureinMF,but,after5years,40%,Maf?(NGSdataavailable)withhigh--70andanestimated5-;131(22):survivalof29%.-,avery-,TefferiA,hiAM,-yearsurvivalafterCon?ict-of-interestdisclosure:-negativeclassicalSCTis34%,withNRMof57%.peting?:revisedman-mendationsfromEuropeansurvivalispoorwitheitheroption,.;32(5):clinicaltrialofnoveltherapyshouldREFERENCES1057-,DitschkowskiM,BogdanovR,,AndersonJE,BandiniG,-molecularAllogeneicstemcelltransplantationtransplantscoringsystemformyelo?brosisforagnogenicmyeloidmetaplasia:aInconclusion,prognosticmodelsareofcrit-;133(20):2233-,Societ′eFran?aisede′blood?16MAY2019|VOLUME133,NUMBER202119FromestonMay23,,GruppoItalianoperIWG-MRT(InternationalWorkingGroupfortransplantation-agepatientswithprimaryilTrapiantodelMidolloOsseo,andMyeloproliferativeNeoplasmsResearchandmyelo?;36(4):FredHutchinsonCancerResearchCenterTreatment).;115(9):1703--;93(9):2831-,inoT,GuglielmelliP,,inoT,MoraB,-clinical-¨N,inoT,ScottBL,-essentialthrom-survivalinpatientswithpostpolycythemiaallogeneicstemcelltransplantationonsur-bocythemiamyelo?brosis:;103(9):myelo?;31(12):primarymyelo?;125(21):e392---3350,,CervantesF,hiAM,,LashoTL,RotunnoG,:mutation-enhancedinterna--2019-03-900860survivalinprimarymyelo?brosis:astudybythetionalprognosticscoresystemfor?2019byTheAmericanSocietyofHematology2120blood?16MAY2019|VOLUME133,NUMBER20FromestonMay23,:2118-2120doi:-2019-03-900860StemcelltransplantinMF:it'stimetopersonalizeFrancescoPassamontiUpdatedinformationandservicescanbefoundat:tent/133/20/(5397articles)Informationaboutreproducingthisarticleinpartsorinitsentiretymaybefoundonlineat:e/misc/#repub_requestsInformationaboutorderingreprintsmaybefoundonlineat:e/misc/#reprintsInformationaboutsubscriptionsandASHmembershipmaybefoundonlineat:e/subscriptions/(printISSN0006-4971,onlineISSN1528-0020),ispublishedweeklybytheAmericanSocietyofHematology,2021LSt,NW,Suite900,;allrightsreserved.