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02.01.2021 | Original Article

Prognosis and risk factors for central nervous system relapse after allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia

verfasst von: Qi Chen, Xiao-Lu Zhu, Xin Zhao, Xiao Liu, Hai-Xia Fu, Yuan-Yuan Zhang, Yu-Hong Chen, Xiao-Dong Mo, Wei Han, Huan Chen, Chen-Hua Yan, Yu Wang, Ying-Jun Chang, Lan-Ping Xu, Xiao-Jun Huang, Xiao-Hui Zhang

Erschienen in: Annals of Hematology | Ausgabe 2/2021

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Abstract

We performed a nested case-control study to investigate the incidence, treatment, and prognosis of central nervous system (CNS) relapse after allogenic hematopoietic stem cell transplantation (allo-HSCT) for acute myeloid leukemia (AML) and compared the outcomes of patients with CNS relapse following haploidentical donor (HID) HSCT versus identical sibling donor (ISD) HSCT. A total of 37 patients (HID-HSCT, 24; ISD-HSCT, 13) developed CNS relapse after transplantation between January 2009 and January 2019, with an incidence of 1.81%. The median time from transplantation to CNS relapse was 239 days. Pre-HSCT CNS involvement (HR 6.940, 95% CI 3.146–15.306, p < .001) was an independent risk factor for CNS relapse after allo-HSCT for AML. The 3-year overall survival (OS) for patients with CNS relapse was 60.3 ± 8.8%, which was significantly lower than that in the controls (81.5 ± 4.5%, p = .003). The incidence of CNS relapse was 1.64% for patients who received HID-HSCT and 2.55% for those who received ISD-HSCT (p = .193). There was no significant difference in OS between the HID-HSCT and ISD-HSCT subgroups among the patients with CNS relapse. In conclusion, CNS relapse is a rare but serious complication after allo-HSCT for AML, and the incidence and outcomes of patients with CNS relapse are comparable following HID-HSCT and ISD-HSCT.

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Gunes G, Goker H, Demiroglu H, Malkan UY, Buyukasik Y (2019) Extramedullary relapses of acute leukemias after allogeneic hematopoietic stem cell transplantation: clinical features, cumulative incidence, and risk factors. Bone Marrow Transplant 54(4):595–600. https://doi.org/10.1038/s41409-018-0303-5CrossRefPubMed

Kim JY, Im SA, Lee JH, Lee JW, Chung NG, Cho B (2016) Extramedullary relapse of acute myeloid and lymphoid leukemia in children: a retrospective analysis. Iran J Pediatr 26(3):e1711. https://doi.org/10.5812/ijp.1711CrossRefPubMedPubMedCentral

Støve HK, Sandahl JD, Abrahamsson J, Asdahl PH, Forestier E, Ha SY et al (2017) Extramedullary leukemia in children with acute myeloid leukemia: a population-based cohort study from the Nordic Society of Pediatric Hematology and Oncology (NOPHO). Pediatr Blood Cancer 64(12). https://doi.org/10.1002/pbc.26520

Del Principe MI, Buccisano F, Soddu S, Maurillo L, Cefalo M, Piciocchi A et al (2018) Involvement of central nervous system in adult patients with acute myeloid leukemia: Incidence and impact on outcome. Semin Hematol 55(4):209–214. https://doi.org/10.1053/j.seminhematol.2018.02.006CrossRefPubMed

Döhner H, Estey EH, Amadori S, Appelbaum FR, Büchner T, Burnett AK et al (2010) Diagnosis and management of acute myeloid leukemia in adults: recommendations from an international expert panel, on behalf of the European LeukemiaNet. Blood 115(3):453–474. https://doi.org/10.1182/blood-2009-07-235358CrossRefPubMed

Basara N, Schulze A, Wedding U, Mohren M, Gerhardt A, Junghanss C et al (2009) Early related or unrelated haematopoietic cell transplantation results in higher overall survival and leukaemia-free survival compared with conventional chemotherapy in high-risk acute myeloid leukaemia patients in first complete remission. Leukemia 23(4):635–640. https://doi.org/10.1038/leu.2008.352CrossRefPubMed

Cornelissen JJ, van Putten WL, Verdonck LF, Theobald M, Jacky E, Daenen SM et al (2007) Results of a HOVON/SAKK donor versus no-donor analysis of myeloablative HLA-identical sibling stem cell transplantation in first remission acute myeloid leukemia in young and middle-aged adults: benefits for whom? Blood 109(9):3658–3666. https://doi.org/10.1182/blood-2006-06-025627CrossRefPubMed

Aoki J, Ishiyama K, Taniguchi S, Fukuda T, Ohashi K, Ogawa H, Kanamori H, Eto T, Iwato K, Sakamaki H, Morishima Y, Nagamura T, Atsuta Y, Takami A (2014) Outcome of allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia patients with central nervous system involvement. Biol Blood Marrow Transplant 20(12):2029–2033. https://doi.org/10.1016/j.bbmt.2014.09.001CrossRefPubMed

Mo XD, Xu LP, Liu DH, Chen YH, Han W, Zhang XH et al (2012) Patients receiving HLA-haploidentical/partially matched related allo-HSCT can achieve desirable health-related QoL that is comparable to that of patients receiving HLA-identical sibling allo-HSCT. Bone Marrow Transplant 47(9):1201–1205. https://doi.org/10.1038/bmt.2011.250CrossRefPubMed

10.

Mo XD, Xu LP, Liu DH, Zhang XH, Chen H, Chen YH et al (2013) Nonmalignant late effects in survivors of partially matched donor hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 195:777–783. https://doi.org/10.1016/j.bbmt.2013.01.026CrossRef

11.

Lv M, Chang Y-J, Huang X-J (2019) Update of the “Beijing Protocol” haplo-identical hematopoietic stem cell transplantation. Bone Marrow Transplant 54(Suppl 2):703–707. https://doi.org/10.1038/s41409-019-0605-2CrossRefPubMed

12.

Wang Y, Liu QF, Xu LP, Liu KY, Zhang XH, Ma X, Fan ZP, Wu DP, Huang XJ (2015) Haploidentical vs identical-sibling transplant for AML in remission: a multicenter, prospective study. Blood 125(25):3956–3962. https://doi.org/10.1182/blood-2015-02-627786CrossRefPubMed

13.

Luo Y, Xiao H, Lai X, Shi J, Tan Y, He J et al (2014) T-cell-replete haploidentical HSCT with low-dose anti-T-lymphocyte globulin compared with matched sibling HSCT and unrelated HSCT. Blood 124(17):2735–2743. https://doi.org/10.1182/blood-2014-04-571570CrossRefPubMedPubMedCentral

14.

Lu D-P, Dong L, Wu T, Huang X-J, Zhang M-J, Han W, Chen H, Liu DH, Gao ZY, Chen YH, Xu LP, Zhang YC, Ren HY, Li D, Liu KY (2006) Conditioning including antithymocyte globulin followed by unmanipulated HLA-mismatched/haploidentical blood and marrow transplantation can achieve comparable outcomes with HLA-identical sibling transplantation. Blood 107(8):3065–3073CrossRefPubMed

15.

Ganem G, Kuentz M, Bernaudin F, Gharbi A, Cordonnier C, Lemerle S et al (1989) Central nervous system relapses after bone marrow transplantation for acute lymphoblastic leukemia in remission. Cancer 64(9):1796–1804. https://doi.org/10.1002/1097-0142(19891101)64:9<1796::aid-cncr2820640907>3.0.co;2-7CrossRefPubMed

16.

Hamdi A, Mawad R, Bassett R, di Stasi A, Ferro R, Afrough A, Ram R, Dabaja B, Rondon G, Champlin R, Sandmaier BM, Doney K, Bar M, Kebriaei P (2014) Central nervous system relapse in adults with acute lymphoblastic leukemia after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 20(11):1767–1771. https://doi.org/10.1016/j.bbmt.2014.07.005CrossRefPubMedPubMedCentral

17.

Chen Q, Zhao X, Fu HX, Chen YH, Zhang YY, Wang JZ et al (2020) Comparison of central nervous system relapse outcomes following haploidentical vs identical-sibling transplant for acute lymphoblastic leukemia. Ann Hematol 99(7):1643–1653. https://doi.org/10.1007/s00277-020-04080-9CrossRefPubMed

18.

Oshima K, Kanda Y, Yamashita T, Takahashi S, Mori T, Nakaseko C et al (2008) Central nervous system relapse of leukemia after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 14(10):1100–1107. https://doi.org/10.1016/j.bbmt.2008.07.002CrossRefPubMed

19.

Solh M, Zhang X, Connor K, Brown S, Solomon SR, Morris LE et al (2016) Post-relapse survival after haploidentical transplantation vs matched-related or matched-unrelated hematopoietic cell transplantation. Bone Marrow Transplant 51(7):949–954. https://doi.org/10.1038/bmt.2016.62CrossRefPubMed

20.

Ma YR, Xu LP, Zhang XH, Yan CH, Wang Y, Wang FR, Wang JZ, Chen Y, Han W, Chen YH, Chen H, Liu KY, Huang XJ (2017) Comparable post-relapse outcomes between haploidentical and matched related donor allogeneic stem cell transplantation. Bone Marrow Transplant 52(3):409–414. https://doi.org/10.1038/bmt.2016.283CrossRefPubMed

21.

Singhal S, Powles R, Treleaven J, Horton C, Tait D, Meller S, Pinkerton CR, Mehta J (1996) Central nervous system relapse after bone marrow transplantation for acute leukemia in first remission. Bone Marrow Transplant 17(4):637–641PubMed

22.

Aldoss I, Al Malki MM, Stiller T, Cao T, Sanchez JF, Palmer J et al (2016) Implications and management of central nervous system involvement before allogeneic hematopoietic cell transplantation in acute lymphoblastic leukemia. Biol Blood Marrow Transplant 22(3):575–578. https://doi.org/10.1016/j.bbmt.2015.10.016CrossRefPubMed

23.

Yan CH, Wang JZ, Liu DH, Xu LP, Chen H, Liu KY et al (2013) Chemotherapy followed by modified donor lymphocyte infusion as a treatment for relapsed acute leukemia after haploidentical hematopoietic stem cell transplantation without in vitro T-cell depletion: superior outcomes compared with chemotherapy alone and an analysis of prognostic factors. Eur J Haematol 91(4):304–314. https://doi.org/10.1111/ejh.12168CrossRefPubMed

24.

Zheng C, Liu X, Zhu W, Cai X, Wu J, Sun Z (2014) Tailored central nervous system-directed treatment strategy for isolated CNS recurrence of adult acute myeloid leukemia. Hematology 19(4):208–212. https://doi.org/10.1179/1607845413y.0000000117CrossRefPubMed

25.

Mo XD, Kong J, Zhao T, Xu LP, Zhang XH, Liu DH, Wang Y, Chen H, Yan CH, Chen YH, Han W, Wang FR, Wang JZ, Liu KY, Huang XJ (2014) Extramedullary relapse of acute leukemia after haploidentical hematopoietic stem cell transplantation: incidence, risk factors, treatment, and clinical outcomes. Biol Blood Marrow Transplant 20(12):2023–2028. https://doi.org/10.1016/j.bbmt.2014.08.023CrossRefPubMed

26.

Yoshihara S, Ikegame K, Kaida K, Taniguchi K, Kato R, Inoue T et al (2012) Incidence of extramedullary relapse after haploidentical SCT for advanced AML/myelodysplastic syndrome. Bone Marrow Transplant 47(5):669–676. https://doi.org/10.1038/bmt.2011.163CrossRefPubMed

27.

Schuurhuis GJ, Heuser M, Freeman S, Béné MC, Buccisano F, Cloos J et al (2018) Minimal/measurable residual disease in AML: a consensus document from the European LeukemiaNet MRD Working Party. Blood 131(12):1275–1291. https://doi.org/10.1182/blood-2017-09-801498CrossRefPubMedPubMedCentral

28.

Yan CH, Wang Y, Wang JZ, Chen YH, Chen Y, Wang FR et al (2016) Minimal residual disease- and graft-vs.-host disease-guided multiple consolidation chemotherapy and donor lymphocyte infusion prevent second acute leukemia relapse after allotransplant. J Hematol Oncol 9(1):87. https://doi.org/10.1186/s13045-016-0319-5CrossRefPubMedPubMedCentral

29.

Lv M, Wang Y, Chang YJ, Zhang XH, Xu LP, Jiang Q et al (2019) Myeloablative haploidentical transplantation is superior to chemotherapy for patients with intermediate-risk acute myelogenous leukemia in first complete remission. Clin Cancer Res 25(6):1737–1748. https://doi.org/10.1158/1078-0432.Ccr-18-1637CrossRefPubMed

30.

Zhao XS, Liu YR, Zhu HH, Xu LP, Liu DH, Liu KY et al (2012) Monitoring MRD with flow cytometry: an effective method to predict relapse for ALL patients after allogeneic hematopoietic stem cell transplantation. Ann Hematol 91(2):183–192. https://doi.org/10.1007/s00277-011-1285-1CrossRefPubMed

31.

Zhao XS, Jin S, Zhu HH, Xu LP, Liu DH, Chen H et al (2012) Wilms’ tumor gene 1 expression: an independent acute leukemia prognostic indicator following allogeneic hematopoietic SCT. Bone Marrow Transplant 47(4):499–507. https://doi.org/10.1038/bmt.2011.121CrossRefPubMed

32.

Wang Y, Wang HX, Lai YR, Sun ZM, Wu DP, Jiang M, Liu DH, Xu KL, Liu QF, Liu L, Wang JB, Gao F, Ou-Yang J, Gao SJ, Xu LP, Huang XJ (2016) Haploidentical transplant for myelodysplastic syndrome: registry-based comparison with identical sibling transplant. Leukemia 30(10):2055–2063. https://doi.org/10.1038/leu.2016.110CrossRefPubMed

33.

Mo XD, Tang BL, Zhang XH, Zheng CC, Xu LP, Zhu XY et al (2016) Comparison of outcomes after umbilical cord blood and unmanipulated haploidentical hematopoietic stem cell transplantation in children with high-risk acute lymphoblastic leukemia. Int J Cancer 139(9):2106–2115. https://doi.org/10.1002/ijc.30249CrossRefPubMed

34.

Przepiorka D, Weisdorf D, Martin P, Klingemann HG, Beatty P, Hows J, Thomas ED (1995) 1994 consensus conference on acute GVHD grading. Bone Marrow Transplant 15(6):825–828PubMed

35.

Jagasia MH, Greinix HT, Arora M, Williams KM, Wolff D, Cowen EW, Palmer J, Weisdorf D, Treister NS, Cheng GS, Kerr H, Stratton P, Duarte RF, McDonald GB, Inamoto Y, Vigorito A, Arai S, Datiles MB, Jacobsohn D, Heller T, Kitko CL, Mitchell SA, Martin PJ, Shulman H, Wu RS, Cutler CS, Vogelsang GB, Lee SJ, Pavletic SZ, Flowers MED (2015) National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: I. The 2014 Diagnosis and Staging Working Group report. Biol Blood Marrow Transplant 21(3):389–401e381. https://doi.org/10.1016/j.bbmt.2014.12.001CrossRefPubMed

36.

Shouval R, Fein JA, Labopin M, Kröger N, Duarte RF, Bader P et al (2019) Outcomes of allogeneic haematopoietic stem cell transplantation from HLA-matched and alternative donors: a European Society for Blood and Marrow Transplantation registry retrospective analysis. Lancet Haematol 6(11):e573–e584. https://doi.org/10.1016/s2352-3026(19)30158-9CrossRefPubMed

37.

Tallman MS, Wang ES, Altman JK, Appelbaum FR, Bhatt VR, Bixby D, Coutre SE, de Lima M, Fathi AT, Fiorella M, Foran JM, Hall AC, Jacoby M, Lancet J, LeBlanc TW, Mannis G, Marcucci G, Martin MG, Mims A, O’Donnell MR, Olin R, Peker D, Perl A, Pollyea DA, Pratz K, Prebet T, Ravandi F, Shami PJ, Stone RM, Strickland SA, Wieduwilt M, Gregory KM, OCN, Hammond L, Ogba N (2019) Acute myeloid leukemia, version 3.2019, NCCN clinical practice guidelines in oncology. Journal of the National Comprehensive Cancer Network : JNCCN 17(6):721–749. https://doi.org/10.6004/jnccn.2019.0028CrossRefPubMed

38.

Wang Y, Chen H, Chen J, Han M, Hu J, Jiong H et al (2018) The consensus on the monitoring, treatment, and prevention of leukemia relapse after allogeneic hematopoietic stem cell transplantation in China. Cancer Lett 438:63–75. https://doi.org/10.1016/j.canlet.2018.08.030CrossRefPubMed

39.

Dekker AW, Elderson A, Punt K, Sixma JJ (1985) Meningeal involvement in patients with acute nonlymphocytic leukemia. Incidence, management, and predictive factors. Cancer 56(8):2078–2082. https://doi.org/10.1002/1097-0142(19851015)56:8<2078::aid-cncr2820560832>3.0.co;2-0CrossRefPubMed

40.

Aoki J, Ishiyama K, Taniguchi S, Fukuda T, Ohashi K, Ogawa H et al (2014) Outcome of allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia patients with central nervous system involvement. Biol Blood Marrow Transplant 20(12):2029–2033. https://doi.org/10.1016/j.bbmt.2014.09.001CrossRefPubMed

41.

Shihadeh F, Reed V, Faderl S, Medeiros LJ, Mazloom A, Hadziahmetovic M et al (2012) Cytogenetic profile of patients with acute myeloid leukemia and central nervous system disease. Cancer 118(1):112–117. https://doi.org/10.1002/cncr.26253CrossRefPubMed

42.

Cheng CL, Li CC, Hou HA, Fang WQ, Chang CH, Lin CT et al (2015) Risk factors and clinical outcomes of acute myeloid leukaemia with central nervous system involvement in adults. BMC Cancer 15:344. https://doi.org/10.1186/s12885-015-1376-9CrossRefPubMedPubMedCentral

43.

Rozovski U, Ohanian M, Ravandi F, Garcia-Manero G, Faderl S, Pierce S et al (2015) Incidence of and risk factors for involvement of the central nervous system in acute myeloid leukemia. Leuk Lymphoma 56(5):1392–1397. https://doi.org/10.3109/10428194.2014.953148CrossRefPubMed

44.

Thompson CB, Sanders JE, Flournoy N, Buckner CD, Thomas ED (1986) The risks of central nervous system relapse and leukoencephalopathy in patients receiving marrow transplants for acute leukemia. Blood 67(1):195–199CrossRefPubMed

45.

Alakel N, Stölzel F, Mohr B, Kramer M, Oelschlägel U, Röllig C et al (2017) Symptomatic central nervous system involvement in adult patients with acute myeloid leukemia. Cancer Manag Res 9:97–102. https://doi.org/10.2147/cmar.S125259CrossRefPubMedPubMedCentral

46.

Johnston DL, Alonzo TA, Gerbing RB, Aplenc R, Woods WG, Meshinchi S et al (2017) Central nervous system disease in pediatric acute myeloid leukemia: a report from the Children;s Oncology Group. Pediatr Blood Cancer 64(12). https://doi.org/10.1002/pbc.26612

47.

Jabbour E, Guastad Daver N, Short NJ, Huang X, Chen HC, Maiti A et al (Am J Hematol, 2017) Factors associated with risk of central nervous system relapse in patients with non-core binding factor acute myeloid leukemia. 92(9):924–928. https://doi.org/10.1002/ajh.24799

48.

Matsumoto K, Yamamoto W, Ogusa E, Ishigatsubo Y, Kanamori H (2014) Prognostic index for relapsed acute leukemia after allogeneic stem cell transplant. Leuk Lymphoma 55(12):2808–2812. https://doi.org/10.3109/10428194.2014.896004CrossRefPubMed

49.

Hoelzer D, Ludwig WD, Thiel E, Gassmann W, Löffler H, Fonatsch C et al (1996) Improved outcome in adult B-cell acute lymphoblastic leukemia. Blood 87(2):495–508CrossRefPubMed

50.

Thomas X, Boiron JM, Huguet F, Dombret H, Bradstock K, Vey N et al (2004) Outcome of treatment in adults with acute lymphoblastic leukemia: analysis of the LALA-94 trial. J Clin Oncol 22(20):4075–4086. https://doi.org/10.1200/jco.2004.10.050CrossRefPubMed

51.

Famoso JM, Grow JL, Laughlin B, Katsanis E, Stea B (2019) The impact of low-dose cranial boost on the long-term outcomes of adult patients with high-risk acute lymphoblastic leukemia undergoing total body irradiation and allogeneic hematopoietic stem cell transplantation. Pract Radiat Oncol 9(3):e283–e289. https://doi.org/10.1016/j.prro.2018.12.005CrossRefPubMed

52.

Gao RW, Dusenbery KE, Cao Q, Smith AR, Yuan J (2018) Augmenting total body irradiation with a cranial boost before stem cell transplantation protects against post-transplant central nervous system relapse in acute lymphoblastic leukemia. Biol Blood Marrow Transplant 24(3):501–506. https://doi.org/10.1016/j.bbmt.2017.11.013CrossRefPubMed

53.

Kozak MM, Yoo CH, Gutkin PM, von Eyben R, Agarwal R, Donaldson SS et al (2020) Central nervous system relapse after stem cell transplantation in adolescents and young adults with acute lymphoblastic leukemia: a single-institution experience. J Adolesc Young Adult Oncol 9(2):166–171. https://doi.org/10.1089/jayao.2019.0121CrossRefPubMed

54.

Hamidieh AA, Monzavi SM, Kaboutari M, Behfar M, Esfandbod M (2017) Outcome analysis of pediatric patients with acute lymphoblastic leukemia treated with total body irradiation-free allogeneic hematopoietic stem cell transplantation: comparison of patients with and without central nervous system involvement. Biol Blood Marrow Transplant 23(12):2110–2117. https://doi.org/10.1016/j.bbmt.2017.08.036CrossRefPubMed

55.

Arellano ML, Langston A, Winton E, Flowers CR, Waller EK (2007) Treatment of relapsed acute leukemia after allogeneic transplantation: a single center experience. Biol Blood Marrow Transplant 13(1):116–123. https://doi.org/10.1016/j.bbmt.2006.09.005CrossRefPubMed

56.

Chang YJ, Huang XJ (2013) Donor lymphocyte infusions for relapse after allogeneic transplantation: when, if and for whom? Blood Rev 27(1):55–62. https://doi.org/10.1016/j.blre.2012.11.002CrossRefPubMed

57.

Mayadev JS, Douglas JG, Storer BE, Appelbaum FR, Storb R (2011) Impact of cranial irradiation added to intrathecal conditioning in hematopoietic cell transplantation in adult acute myeloid leukemia with central nervous system involvement. Int J Radiat Oncol Biol Phys 80(1):193–198. https://doi.org/10.1016/j.ijrobp.2010.01.062CrossRefPubMed

58.

Shi JM, Meng XJ, Luo Y, Tan YM, Zhu XL, Zheng GF, He JS, Zheng WY, Xie WZ, Li L, Ye XJ, Zhang J, Cai Z, Lin MF, Huang H (2013) Clinical characteristics and outcome of isolated extramedullary relapse in acute leukemia after allogeneic stem cell transplantation: a single-center analysis. Leuk Res 37(4):372–377. https://doi.org/10.1016/j.leukres.2012.12.002CrossRefPubMed

59.

Oshima K, Kanda Y, Yamashita T, Takahashi S, Mori T, Nakaseko C, Fujimaki K, Yokota A, Fujisawa S, Matsushima T, Fujita H, Sakura T, Okamoto S, Maruta A, Sakamaki H, Kanto Study Group for Cell Therapy (2008) Central nervous system relapse of leukemia after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 14(10):1100–1107CrossRefPubMed

Titel: Prognosis and risk factors for central nervous system relapse after allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia
verfasst von: Qi Chen
Xiao-Lu Zhu
Xin Zhao
Xiao Liu
Hai-Xia Fu
Yuan-Yuan Zhang
Yu-Hong Chen
Xiao-Dong Mo
Wei Han
Huan Chen
Chen-Hua Yan
Yu Wang
Ying-Jun Chang
Lan-Ping Xu
Xiao-Jun Huang
Xiao-Hui Zhang
Publikationsdatum: 02.01.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: Annals of Hematology / Ausgabe 2/2021
Print ISSN: 0939-5555
Elektronische ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-020-04380-0

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Prognosis and risk factors for central nervous system relapse after allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia

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