Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2023; 22: 16-23
Результаты трансплантации гемопоэтических стволовых клеток у детей с острыми лейкозами: опыт одного Центра
https://doi.org/10.24287/1726-1708-2023-22-2-16-23Аннотация
Аллогенная трансплантация гемопоэтических стволовых клеток (алло-ТГСК) в настоящее время является эффективным методом лечения, рецидивирующего / рефрактерного (Р / Р) острого лейкоза (ОЛ) и ОЛ высокого риска. В статье представлен собственный опыт проведения алло-ТГСК у детей с Р / Р ОЛ. Настоящее исследование одобрено независимым этическим комитетом и утверждено решением ученого совета НМИЦ онкологии им. Н. Н. Блохина. В исследование был включен 51 пациент с Р / Р ОЛ: 32 пациента с острым лимфобластным лейкозом (ОЛЛ), 17 – с острым миелоидным лейкозом (ОМЛ), 2 – с бифенотипическим лейкозом (БЛ). Всем пациентам была выполнена алло-ТГСК в период с января 2021 г. по октябрь 2022 г. Медиана возраста составила 8,7 года (5 месяцев – 17 лет). На момент выполнения трансплантации во 2-й ремиссии и более находились 26 пациентов, остальные – в 1-й клинико-гематологической ремиссии (ОМЛ высокого риска и рефрактерный ОЛЛ). От гаплоидентичного донора алло-ТГСК была выполнена 21 (41,2 %) пациенту, от HLA-совместимого родственного донора – 19 (37,2 %), от HLA-совместимого неродственного донора – 11 (21,6 %). Предтрансплантационное кондиционирование при ОЛЛ у 27 пациентов включало режимы на основе тотального облучения тела в дозе 12 Гр, у 4 – на основе бусульфана и у 1 больного применялся треосульфан. При ОМЛ и БЛ использовались режимы кондиционирования на основе треосульфана / тиотепы (n = 10), треосульфана / мелфалана (n = 8) или бусульфана / мелфалана (n = 1). В качестве источника гемопоэтических стволовых клеток у 14 пациентов использовался костный мозг, у 37 – периферические стволовые клетки крови. При гаплоидентичных алло-ТГСК в целях профилактики реакции «трансплантат против хозяина» (РТПХ) у 15 пациентов выполнялась TCRab/CD19-деплеция с последующим дополнительным назначением на –1-й день абатацепта / тоцилизумаба / ритуксимаба, 6 больным вводился посттрансплантационный циклофосфамид. При трансплантациях от HLA-совместимых родственных и неродственных доноров пациенты получали комбинированную иммуносупрессивную терапию с абатацептом и ритуксимабом на –1-й день, а в качестве базовой иммуносупрессивной терапии применялись ингибиторы кальциневрина. У всех пациентов было зафиксировано приживление трансплантата с медианой на 13-е (9–24-е) сутки после алло-ТГСК. У 8 (15,7 %) пациентов на разных сроках после алло-ТГСК констатирован рецидив ОЛ, из них живы 5. При медиане наблюдения 9 (5–25) мес получены следующие показатели выживаемости пациентов с ОЛ: общая выживаемость составила 76,4 %, безрецидивная выживаемость – 68,8 %. Развитие острой РТПХ отмечено у 72,5 % детей, РТПХ III–IV степени – у 5,3 %, хронической РТПХ – у 13,7 %. Развитие инфекционных осложнений раннего посттрансплантационного периода отмечено у большинства больных: фебрильная нейтропения – у 96,0 %, реактивация виремии – у 47,3 %, орофарингеальный мукозит – у 78,4 %, острый цистит – у 12,3 %. Общая летальность составила 17,6 %. Поздняя летальность была ассоциирована с рецидивом ОЛ.
Список литературы
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2. Allemani C., Matsuda T., Di Carlo V., Harewood R., Matz M., Nikšić M., et al.; CONCORD Working Group. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet 2018; 391 (10125): 1023–75. DOI: 10.1016/S0140-6736(17)33326-3
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4. Ceppi F., Duval M., Leclerc J. M., Laverdiere C., Delva Y. L., Cellot S., et al. Improvement of the Outcome of Relapsed or Refractory Acute Lymphoblastic Leukemia in Children Using a Risk-Based Treatment Strategy. PLoS One 2016; 11 (9): e0160310. DOI: 10.1371/journal.pone.0160310
5. Coustan-Smith E., Gajjar A., Hijiya N., Razzouk B. I., Ribeiro R. C., Rivera G. K., et al. Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia after first relapse. Leukemia 2004; 18 (3): 499–504. DOI: 10.1038/sj.leu.2403283
6. Raetz E. A., Borowitz M. J., Devidas M., Linda S. B., Hunger S. P., Winick N. J., et al. Reinduction platform for children with first marrow relapse of acute lymphoblastic Leukemia: A Children's Oncology Group Study [corrected]. J Clin Oncol 2008; 26 (24): 3971–8. Epub 2008 / 08 / 20. DOI: 10.1200/jco.2008.16.1414
7. Verneris M. R., Ma Q., Zhang J., Keating A., Tiwari R., Li J., et al. Indirect comparison of tisagenlecleucel and blinatumomab in pediatric relapsed / refractory acute lymphoblastic leukemia. Blood Adv 2021; 5 (23): 5387–95. DOI: 10.1182/bloodadvances.2020004045
8. Brivio E., Locatelli F., Lopez-Yurda M., Malone A., Díaz-de-Heredia C., Bielorai B., et al. A phase 1 study of inotuzumab ozogamicin in pediatric relapsed/refractory acute lymphoblastic leukemia (ITCC-059 study). Blood 2021; 137 (12): 1582–90. DOI: 10.1182/blood.2020007848
9. Rosenthal J., Naqvi A. S., Luo M., Wertheim G., Paessler M., Thomas-Tikhonenko A., et al. Heterogeneity of surface CD19 and CD22 expression in B lymphoblastic leukemia. Am J Hematol 2018; 93 (11): E352–5.
10. Kantarjian H. M., De Angelo D. J., Stelljes M., Martinelli G., Liedtke M., Stock W., et al. Inotuzumab ozogamicin versus standard therapy for acute lymphoblastic leukemia. N Engl J Med 2016; 375 (8): 740–53.
11. Sadelain M., Rivière I., Riddell S. Therapeutic T cell engineering. Nature 2017; 545 (7655): 423–31.
12. Buechner J., Caruana I., Künkele A., Rives S., Vettenranta K., Bader P., et al. Chimeric Antigen Receptor T-Cell Therapy in Paediatric B-Cell Precursor Acute Lymphoblastic Leukaemia: Curative Treatment Option or Bridge to Transplant? Front Pediatr 2022; 9: 784024. DOI: 10.3389/fped.2021.784024
13. Maude S. L., Laetsch T. W., Buechner J., Rives S., Boyer M., Bittencourt H., et al. Tisagenlecleucel in Children and Young Adults with B-Cell Lymphoblastic Leukemia. N Engl J Med 2018; 378 (5): 439–48. DOI: 10.1056/NEJMoa1709866
14. Peters C., Dalle J. H., Locatelli F., Poetschger U., Sedlacek P., Buechner J., et al. Total body irradiation or chemotherapy conditioning in childhood ALL: a multinational, randomized, noninferiority Phase III study. J Clin Oncol 2021; 39: 295–307. DOI: 10.1200/JCO.20.02529
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16. Han X., Wang Y., Wei J., Han W. Multi-antigen-targeted chimeric antigen receptor T cells for cancer therapy. J Hematol Oncol 2019; 12: 128. DOI: 10.1186/s13045-019-0813-7
17. Merli P., Algeri M., Del Bufalo F., Locatelli F. Hematopoietic Stem Cell Transplantation in Pediatric Acute Lymphoblastic Leukemia. Curr Hematol Malig Rep 2019; 14 (2): 94–105. DOI: 10.1007/s11899-019-00502-2
18. Lee J. W., Kang H. J., Kim S., Lee S. H., Yu K. S., Kim N. H., et al. Favorable outcome of hematopoietic stem cell transplantation using a targeted once-daily intravenous busulfan-fludarabine-etoposide regimen in pediatric and infant acute lymphoblastic leukemia patients. Biol Blood Marrow Transplant 2015; 21 (1): 190–5. DOI: 10.1016/j.bbmt.2014.09.013
19. Bader P., Kreyenberg H., Henze G. H., Eckert C., Reising M., Willasch A., et al. Prognostic value of minimal residual disease quantification before allogeneic stem-cell transplantation in relapsed childhood acute lymphoblastic leukemia: the ALL-REZ BFM Study Group. Journal of clinical oncology: official journal of the Am Soc Clin Oncol 2009; 27 (3): 377–84. DOI: 10.1200/jco.2008.17.6065
20. Rasche M., Zimmermann M., Borschel L., Bourquin J. P., Dworzak M., Klingebiel T., et аl. Successes and challenges in the treatment of pediatric acute myeloid leukemia: A retrospective analysis of the AML-BFM trials from 1987 to 2012. Leukemia 2018; 32: 2167–77. DOI: 10.1038/s41375-018-0071-7
21. Rasche M., Zimmermann M., Steidel E., Alonzo T., Aplenc R., Bourquin J. P., еt аl. Survival Following Relapse in Children with Acute Myeloid Leukemia: A Report from AML-BFM and COG. Cancers (Basel) 2021; 13 (10): 2336. DOI: 10.3390/cancers13102336
22. Zwaan C. M., Kolb E. A., Reinhardt D., Abrahamsson J., Adachi S., Aplenc R., et аl. Collaborative Efforts Driving Progress in Pediatric Acute Myeloid Leukemia. J Clin Oncol 2015; 33: 2949–62. DOI: 10.1200/JCO.2015.62.8289
23. Aird W. C. Phenotypic heterogeneity of the endothelium: I. Structure, function, and mechanisms. Circ Res 2007; 100 (2): 158–73. DOI: 10.1161/01.RES.0000255691.76142.4a
24. Rasche M., Zimmermann M., Steidel E., Alonzo T., Aplenc R., Bourquin J. P., et al. Survival Following Relapse in Children with Acute Myeloid Leukemia: A Report from AML-BFM and COG. Cancers (Basel) 2021; 13 (10): 2336. DOI: 10.3390/cancers13102336
25. Reinhardt D., Antoniou E., Waack K. Pediatric Acute Myeloid Leukemia-Past, Present, and Future. J Clin Med 2022; 11 (3): 504. DOI: 10.3390/jcm11030504
26. Cacace F., Iula R., De Novellis D., Caprioli V., D'Amico M. R., De Simone G., et al. High-Risk Acute Myeloid Leukemia: A Pediatric Prospective. Biomedicines 2022; 10 (6): 1405. DOI: 10.3390/biomedicines10061405
27. Lamble A. J., Tasian S. K. Opportunities for immunotherapy in childhood acute myeloid leukemia. Blood Adv 2019; 3: 3750–8.
28. Gill S., Tasian S. K., Ruella M., Shestova O., Li Y., Porter D. L., et al. Preclinical target in g of human acute myeloid leukemia and myeloablation using chimeric antigen receptor-modified T cells. Blood 2014; 123: 2343–54.
29. Cooper T. M., Absalon M. J., Alonzo T. A., Gerbing R. B., Leger K. J., Hirsch B. A. et al. Phase I/II Study of CPX-351 Followed by Fludarabine, Cytarabine, and Granulocyte-Colony Stimulating Factor for Children with Relapsed Acute Myeloid Leukemia: A Report from the Children’s Oncology Group. J Clin Oncol 2020; 38: 2170–7.
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31. Riberdy J. M., Zhou S., Zheng F., Kim Y. I., Moore J., Vaidya A., et al. The Art and Science of Selecting a CD123-Specific Chimeric Antigen Receptor for Clinical Testing. Mol Ther Methods Clin Dev 2020; 18: 571–81.
32. Wang J., Zhao J., Fei X., Yin Y., Cheng H., Zhang W., et al. A new intensive conditioning regimen for allogeneic hematopoietic stem cell transplantation in patients with refractory or relapsed acute myeloid leukemia. Medicine (Baltimore) 2018; 97 (17): e0228. DOI: 10.1097/MD.0000000000010228
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Pediatric Hematology/Oncology and Immunopathology. 2023; 22: 16-23
Results of hematopoietic stem cell transplantation in children with acute leukemia: a single-center experience
https://doi.org/10.24287/1726-1708-2023-22-2-16-23Abstract
Currently, allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an effective treatment option for relapsed / refractory (R / R) acute leukemia (AL) and high-risk AL. In this article, we present our own experience of allo-HSCT in children with R / R AL. The study was approved by the Independent Ethics Committee and the Scientific Council of the N. N. Blokhin National Medical Research Center of Oncology. Fifty-one patients with R / R AL were included in the study: 32 patients had acute lymphoblastic leukemia (ALL), 17 patients had acute myeloid leukemia (AML) and 2 patients had biphenotypic leukemia (BL). All patients underwent allo-HSCT from January 2021 to October 2022. The median age was 8.7 years (5 months – 17 years). At the time of allo-HSCT, 26 patients were in the second (and further) remission, the rest were in the first clinical and hematologic remission (high-risk AML and refractory ALL). Twenty-one (41.2 %) patients received allo-HSCT from a haploidentical donor, 19 (37.2 %) patients underwent allo-HSCT from an HLA-matched related donor and 11 (21.6 %) patients – from an HLA-matched unrelated donor. Pre-transplant conditioning in ALL: 27 patients received regimens based on total body irradiation at a dose of 12 Gy, 4 patients received busulfan-based conditioning regimens, and in 1 patient we used treosulfan. In AML and BL, we used conditioning regimens based on treosulfan/thiotepa (n = 10), treosulfan/melphalan (n = 8) or busulfan / melphalan (n = 1). Bone marrow (in 14 patients) and peripheral blood stem cells (in 37 patients) were used as a source of hematopoietic stem cells. In haploidentical allo-HSCTs in order to prevent graft-versus-host disease (GVHD) we performed TCRab/CD19 depletion followed by additional administration of abatacept / tocilizumab / rituximab on day –1 in 15 patients, 6 patients received post-transplant cyclophosphamide. In transplantations from HLA-matched related and unrelated donors, patients received combined immunosuppressive therapy with abatacept and rituximab on day –1, and calcineurin inhibitors were used as basic immunosuppressive therapy. All patients engrafted with a median time to engraftment of 13 (range, 9 to 24) days after allo-HSCT. Eight (15.7 %) patients developed a relapse of AL at different times after HSCT (five of them are alive). At the median follow-up of 9 (5–25) months, the overall and disease-free survival survival rates were 76.4 % and 68.8 %, respectively, for patients with AL. Acute GVHD was observed in 72.5 % of children, grade 3–4 GVHD was observed in 5.3 % of patients, and 13.7 % of children developed chronic GVHD. Most patients developed infectious complications in the early post-transplant period: febrile neutropenia (96.0 %), reactivation of viremia (47.3 %,) oropharyngeal mucositis (78.4 %), acute cystitis (12.3 %). The overall mortality rate was 17.6 %. Late mortality was associated with a relapse of AL.
References
1. Wang X. J., Wang Y. H., Ong M. J. C., Gkitzia C., Soh S. Y., Hwang W. Y. K. Cost-Effectiveness and Budget Impact Analyses of Tisagenlecleucel in Pediatric and Young Adult Patients with Relapsed or Refractory B-Cell Acute Lymphoblastic Leukemia from the Singapore Healthcare System Perspective. Clinicoecon Outcomes Res 2022; 14: 333–55. DOI: 10.2147/CEOR.S355557
2. Allemani C., Matsuda T., Di Carlo V., Harewood R., Matz M., Nikšić M., et al.; CONCORD Working Group. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet 2018; 391 (10125): 1023–75. DOI: 10.1016/S0140-6736(17)33326-3
3. Pui C. H., Carroll W. L., Meshinchi S., Arceci R. J. Biology, risk stratification, and therapy of pediatric acute leukemias: an update. J Clin Oncol 2011; 29 (5): 551–65. DOI: 10.1200/jco.2010.30.7405
4. Ceppi F., Duval M., Leclerc J. M., Laverdiere C., Delva Y. L., Cellot S., et al. Improvement of the Outcome of Relapsed or Refractory Acute Lymphoblastic Leukemia in Children Using a Risk-Based Treatment Strategy. PLoS One 2016; 11 (9): e0160310. DOI: 10.1371/journal.pone.0160310
5. Coustan-Smith E., Gajjar A., Hijiya N., Razzouk B. I., Ribeiro R. C., Rivera G. K., et al. Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia after first relapse. Leukemia 2004; 18 (3): 499–504. DOI: 10.1038/sj.leu.2403283
6. Raetz E. A., Borowitz M. J., Devidas M., Linda S. B., Hunger S. P., Winick N. J., et al. Reinduction platform for children with first marrow relapse of acute lymphoblastic Leukemia: A Children's Oncology Group Study [corrected]. J Clin Oncol 2008; 26 (24): 3971–8. Epub 2008 / 08 / 20. DOI: 10.1200/jco.2008.16.1414
7. Verneris M. R., Ma Q., Zhang J., Keating A., Tiwari R., Li J., et al. Indirect comparison of tisagenlecleucel and blinatumomab in pediatric relapsed / refractory acute lymphoblastic leukemia. Blood Adv 2021; 5 (23): 5387–95. DOI: 10.1182/bloodadvances.2020004045
8. Brivio E., Locatelli F., Lopez-Yurda M., Malone A., Díaz-de-Heredia C., Bielorai B., et al. A phase 1 study of inotuzumab ozogamicin in pediatric relapsed/refractory acute lymphoblastic leukemia (ITCC-059 study). Blood 2021; 137 (12): 1582–90. DOI: 10.1182/blood.2020007848
9. Rosenthal J., Naqvi A. S., Luo M., Wertheim G., Paessler M., Thomas-Tikhonenko A., et al. Heterogeneity of surface CD19 and CD22 expression in B lymphoblastic leukemia. Am J Hematol 2018; 93 (11): E352–5.
10. Kantarjian H. M., De Angelo D. J., Stelljes M., Martinelli G., Liedtke M., Stock W., et al. Inotuzumab ozogamicin versus standard therapy for acute lymphoblastic leukemia. N Engl J Med 2016; 375 (8): 740–53.
11. Sadelain M., Rivière I., Riddell S. Therapeutic T cell engineering. Nature 2017; 545 (7655): 423–31.
12. Buechner J., Caruana I., Künkele A., Rives S., Vettenranta K., Bader P., et al. Chimeric Antigen Receptor T-Cell Therapy in Paediatric B-Cell Precursor Acute Lymphoblastic Leukaemia: Curative Treatment Option or Bridge to Transplant? Front Pediatr 2022; 9: 784024. DOI: 10.3389/fped.2021.784024
13. Maude S. L., Laetsch T. W., Buechner J., Rives S., Boyer M., Bittencourt H., et al. Tisagenlecleucel in Children and Young Adults with B-Cell Lymphoblastic Leukemia. N Engl J Med 2018; 378 (5): 439–48. DOI: 10.1056/NEJMoa1709866
14. Peters C., Dalle J. H., Locatelli F., Poetschger U., Sedlacek P., Buechner J., et al. Total body irradiation or chemotherapy conditioning in childhood ALL: a multinational, randomized, noninferiority Phase III study. J Clin Oncol 2021; 39: 295–307. DOI: 10.1200/JCO.20.02529
15. Willasch A. M., Peters C., Sedlacek P., Dalle J. H., Kitra-Roussou V., Yesilipek A., et al. Myeloablative conditioning for allo-HSCT in pediatric ALL: FTBI or chemotherapy?-a multicenter EBMT-PDWP study. Bone Marrow Transplant 2020; 55: 1540–51. DOI: 10.1038/s41409-020-0854-0
16. Han X., Wang Y., Wei J., Han W. Multi-antigen-targeted chimeric antigen receptor T cells for cancer therapy. J Hematol Oncol 2019; 12: 128. DOI: 10.1186/s13045-019-0813-7
17. Merli P., Algeri M., Del Bufalo F., Locatelli F. Hematopoietic Stem Cell Transplantation in Pediatric Acute Lymphoblastic Leukemia. Curr Hematol Malig Rep 2019; 14 (2): 94–105. DOI: 10.1007/s11899-019-00502-2
18. Lee J. W., Kang H. J., Kim S., Lee S. H., Yu K. S., Kim N. H., et al. Favorable outcome of hematopoietic stem cell transplantation using a targeted once-daily intravenous busulfan-fludarabine-etoposide regimen in pediatric and infant acute lymphoblastic leukemia patients. Biol Blood Marrow Transplant 2015; 21 (1): 190–5. DOI: 10.1016/j.bbmt.2014.09.013
19. Bader P., Kreyenberg H., Henze G. H., Eckert C., Reising M., Willasch A., et al. Prognostic value of minimal residual disease quantification before allogeneic stem-cell transplantation in relapsed childhood acute lymphoblastic leukemia: the ALL-REZ BFM Study Group. Journal of clinical oncology: official journal of the Am Soc Clin Oncol 2009; 27 (3): 377–84. DOI: 10.1200/jco.2008.17.6065
20. Rasche M., Zimmermann M., Borschel L., Bourquin J. P., Dworzak M., Klingebiel T., et al. Successes and challenges in the treatment of pediatric acute myeloid leukemia: A retrospective analysis of the AML-BFM trials from 1987 to 2012. Leukemia 2018; 32: 2167–77. DOI: 10.1038/s41375-018-0071-7
21. Rasche M., Zimmermann M., Steidel E., Alonzo T., Aplenc R., Bourquin J. P., et al. Survival Following Relapse in Children with Acute Myeloid Leukemia: A Report from AML-BFM and COG. Cancers (Basel) 2021; 13 (10): 2336. DOI: 10.3390/cancers13102336
22. Zwaan C. M., Kolb E. A., Reinhardt D., Abrahamsson J., Adachi S., Aplenc R., et al. Collaborative Efforts Driving Progress in Pediatric Acute Myeloid Leukemia. J Clin Oncol 2015; 33: 2949–62. DOI: 10.1200/JCO.2015.62.8289
23. Aird W. C. Phenotypic heterogeneity of the endothelium: I. Structure, function, and mechanisms. Circ Res 2007; 100 (2): 158–73. DOI: 10.1161/01.RES.0000255691.76142.4a
24. Rasche M., Zimmermann M., Steidel E., Alonzo T., Aplenc R., Bourquin J. P., et al. Survival Following Relapse in Children with Acute Myeloid Leukemia: A Report from AML-BFM and COG. Cancers (Basel) 2021; 13 (10): 2336. DOI: 10.3390/cancers13102336
25. Reinhardt D., Antoniou E., Waack K. Pediatric Acute Myeloid Leukemia-Past, Present, and Future. J Clin Med 2022; 11 (3): 504. DOI: 10.3390/jcm11030504
26. Cacace F., Iula R., De Novellis D., Caprioli V., D'Amico M. R., De Simone G., et al. High-Risk Acute Myeloid Leukemia: A Pediatric Prospective. Biomedicines 2022; 10 (6): 1405. DOI: 10.3390/biomedicines10061405
27. Lamble A. J., Tasian S. K. Opportunities for immunotherapy in childhood acute myeloid leukemia. Blood Adv 2019; 3: 3750–8.
28. Gill S., Tasian S. K., Ruella M., Shestova O., Li Y., Porter D. L., et al. Preclinical target in g of human acute myeloid leukemia and myeloablation using chimeric antigen receptor-modified T cells. Blood 2014; 123: 2343–54.
29. Cooper T. M., Absalon M. J., Alonzo T. A., Gerbing R. B., Leger K. J., Hirsch B. A. et al. Phase I/II Study of CPX-351 Followed by Fludarabine, Cytarabine, and Granulocyte-Colony Stimulating Factor for Children with Relapsed Acute Myeloid Leukemia: A Report from the Children’s Oncology Group. J Clin Oncol 2020; 38: 2170–7.
30. Lancet J. E., Uy G. L., Cortes J. E., Newell L. F., Lin T. L., Ritchie E. K., et al. CPX-351 (cytarabine and daunorubicin) Liposome for Injection Versus Conventional Cytarabine Plus Daunorubicin in Older Patients with Newly Diagnosed Secondary Acute Myeloid Leukemia. J Clin Oncol 2018; 36: 2684–92.
31. Riberdy J. M., Zhou S., Zheng F., Kim Y. I., Moore J., Vaidya A., et al. The Art and Science of Selecting a CD123-Specific Chimeric Antigen Receptor for Clinical Testing. Mol Ther Methods Clin Dev 2020; 18: 571–81.
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