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Lancet Haematol:HSCT治疗60岁及以上急性髓系白血病患者缓解后的治疗

2015-09-19 崔倩 译 MedSci原创

急性髓细胞白血病主要影响老年人,并且在中位年龄为70岁左右时被诊断。尽管约50-60%的患者在进入密集的诱导化疗后可以完全缓解,但复发率仍然很高,总的结果是令人失望的。因此,有效的缓解后治疗是迫切需要的。虽然通常没有缓解后疗法给予老年患者,它可能包括化疗或同种异体造血干细胞移植(HSCT)之后降低强度调节。该研究的目的是评估比较异体移植与其他方法,包括无缓解后治疗,对于年龄在60岁以上急性髓性白血

急性髓细胞白血病主要影响老年人,并且在中位年龄为70岁左右时被诊断。尽管约50-60%的患者在进入密集的诱导化疗后可以完全缓解,但复发率仍然很高,总的结果是令人失望的。因此,有效的缓解后治疗是迫切需要的。通常给予老年患者的是无缓解后治疗,它可能包括化疗或同种异体造血干细胞移植(HSCT)之后的强度降低调节。该研究的目的是评估比较异体移植与其他方法,包括无缓解后治疗,对于年龄在60岁以上的急性髓性白血病患者的效果。

对于这项时间依赖性的分析,研究人员使用了来自四个连续前瞻性HOVON-SAKK急性髓细胞白血病的试验结果。在2001年5月3日和2010年2月5日之间,共有1155例60岁或以上的患者参加这些试验,其中640例患者在诱导化疗后获得第一次完全缓解,被纳入分析。缓解后治疗包括HSCT后减少强度调节(n=97)、吉妥珠单抗(n=110)、化疗(n=44)、自体造血干细胞移植(n=23),或不作处理(n=366 )。减低强度预处理方案包括氟达拉滨结合2 Gy全身照射(n=71),氟达拉滨与白消安(n =10),或其他方案(n=16)。一项随时间变化的分析工作已经完成,其中同种异体HSCT与其它类型的缓解后治疗进行了比较。该研究的主要终点是所有治疗组的5年生存率,由一个时间依赖性分析完成。

接受异体造血干细胞移植的患者5年生存率为35%(95%ClI 25-44),对于那些没有接受额外的缓解后治疗的患者为21%(17-26),那些接受额外的化疗或自体造血干细胞移植的患者为26%(19-33)。 5年总生存率受到了欧洲LeukemiaNET急性髓系白血病风险评分的强烈影响,有利风险组的患者患(n= 65)(56%[95%Cl 43-67])比那些具有中等风险(n=131;23%[19-27])或不利风险(n= 444;13%[8-20])急性髓系白血病患者具有较好的5年总生存率。将异体HSCT作为时间相关的变量的多变量分析显示,与非同种异基因造血干细胞移植治疗后缓解或缓解后治疗相比,尤其是在中危患者(0.82 [ 0.58–1.15 ])或不利的风险(0.39 [ 0.21–0.73 ])急性髓系白血病患者,同种异体HSCT有更好的5年生存率(HR 0.71 [95%Cl 0.53-0.95],p=0.017).

总的来说,这四个试验的结果表明,异基因造血干细胞移植可能是60岁及以上具有中等风险,并在第一次完全缓解的具有不利风险的急性髓系白血病患者的首选治疗方法,但比较价值在一个前瞻性随机对照研究中应该被理想的显示。

原始出处:

Jurjen Versluis, Carin L E Hazenberg, Jakob R Passweg, et al.Post-remission treatment with allogeneic stem cell transplantation in patients aged 60 years and older with acute myeloid leukaemia, Lancet Haematology,2015.9.17

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    2016-05-24 howi
  2. [GetPortalCommentsPageByObjectIdResponse(id=1828223, encodeId=d0fa1828223e2, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue May 24 12:26:00 CST 2016, time=2016-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1658585, encodeId=b50916585857a, content=<a href='/topic/show?id=4d06914052' target=_blank style='color:#2F92EE;'>#HSC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9140, encryptionId=4d06914052, topicName=HSC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4bd24890262, createdName=sjq035, createdTime=Wed Sep 30 21:26:00 CST 2015, time=2015-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008207, encodeId=4a6c200820e34, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Sat Oct 31 19:26:00 CST 2015, time=2015-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1822031, encodeId=938318220315a, content=<a href='/topic/show?id=ee4b1021266e' target=_blank style='color:#2F92EE;'>#髓系白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102126, encryptionId=ee4b1021266e, topicName=髓系白血病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b79433, createdName=fangcong, createdTime=Fri Sep 25 21:26:00 CST 2015, time=2015-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37608, encodeId=398a3e608cd, content=60岁及以上急性髓系白血病患者耐受性差,治疗较困难, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a1a01625167, createdName=zhouxue1990, createdTime=Thu Oct 01 12:25:00 CST 2015, time=2015-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37093, encodeId=df013e09351, content=在中国这样的trial比较难吧。, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=18bb1631067, createdName=xingcy, createdTime=Mon Sep 21 13:14:00 CST 2015, time=2015-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1317238, encodeId=588f131e2387b, content=<a href='/topic/show?id=74916e0414' target=_blank style='color:#2F92EE;'>#EMA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6704, encryptionId=74916e0414, topicName=EMA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Mon Sep 21 08:26:00 CST 2015, time=2015-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1578419, encodeId=2c5c15e8419b0, content=<a href='/topic/show?id=cabf914424' target=_blank style='color:#2F92EE;'>#HSCT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9144, encryptionId=cabf914424, topicName=HSCT)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0df016405434, createdName=ms691033630344116, createdTime=Mon Sep 21 08:26:00 CST 2015, time=2015-09-21, status=1, ipAttribution=)]
    2015-09-30 sjq035
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    2015-10-31 changfy
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1828223, encodeId=d0fa1828223e2, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue May 24 12:26:00 CST 2016, time=2016-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1658585, encodeId=b50916585857a, content=<a href='/topic/show?id=4d06914052' target=_blank style='color:#2F92EE;'>#HSC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9140, encryptionId=4d06914052, topicName=HSC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4bd24890262, createdName=sjq035, createdTime=Wed Sep 30 21:26:00 CST 2015, time=2015-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008207, encodeId=4a6c200820e34, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Sat Oct 31 19:26:00 CST 2015, time=2015-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1822031, encodeId=938318220315a, content=<a href='/topic/show?id=ee4b1021266e' target=_blank style='color:#2F92EE;'>#髓系白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102126, encryptionId=ee4b1021266e, topicName=髓系白血病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b79433, createdName=fangcong, createdTime=Fri Sep 25 21:26:00 CST 2015, time=2015-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37608, encodeId=398a3e608cd, content=60岁及以上急性髓系白血病患者耐受性差,治疗较困难, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a1a01625167, createdName=zhouxue1990, createdTime=Thu Oct 01 12:25:00 CST 2015, time=2015-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37093, encodeId=df013e09351, content=在中国这样的trial比较难吧。, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=18bb1631067, createdName=xingcy, createdTime=Mon Sep 21 13:14:00 CST 2015, time=2015-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1317238, encodeId=588f131e2387b, content=<a href='/topic/show?id=74916e0414' target=_blank style='color:#2F92EE;'>#EMA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6704, encryptionId=74916e0414, topicName=EMA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Mon Sep 21 08:26:00 CST 2015, time=2015-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1578419, encodeId=2c5c15e8419b0, content=<a href='/topic/show?id=cabf914424' target=_blank style='color:#2F92EE;'>#HSCT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9144, encryptionId=cabf914424, topicName=HSCT)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0df016405434, createdName=ms691033630344116, createdTime=Mon Sep 21 08:26:00 CST 2015, time=2015-09-21, status=1, ipAttribution=)]
    2015-10-01 zhouxue1990

    60岁及以上急性髓系白血病患者耐受性差,治疗较困难

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1828223, encodeId=d0fa1828223e2, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue May 24 12:26:00 CST 2016, time=2016-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1658585, encodeId=b50916585857a, content=<a href='/topic/show?id=4d06914052' target=_blank style='color:#2F92EE;'>#HSC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9140, encryptionId=4d06914052, topicName=HSC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4bd24890262, createdName=sjq035, createdTime=Wed Sep 30 21:26:00 CST 2015, time=2015-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008207, encodeId=4a6c200820e34, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Sat Oct 31 19:26:00 CST 2015, time=2015-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1822031, encodeId=938318220315a, content=<a href='/topic/show?id=ee4b1021266e' target=_blank style='color:#2F92EE;'>#髓系白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102126, encryptionId=ee4b1021266e, topicName=髓系白血病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b79433, createdName=fangcong, createdTime=Fri Sep 25 21:26:00 CST 2015, time=2015-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37608, encodeId=398a3e608cd, content=60岁及以上急性髓系白血病患者耐受性差,治疗较困难, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a1a01625167, createdName=zhouxue1990, createdTime=Thu Oct 01 12:25:00 CST 2015, time=2015-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37093, encodeId=df013e09351, content=在中国这样的trial比较难吧。, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=18bb1631067, createdName=xingcy, createdTime=Mon Sep 21 13:14:00 CST 2015, time=2015-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1317238, encodeId=588f131e2387b, content=<a href='/topic/show?id=74916e0414' target=_blank style='color:#2F92EE;'>#EMA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6704, encryptionId=74916e0414, topicName=EMA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Mon Sep 21 08:26:00 CST 2015, time=2015-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1578419, encodeId=2c5c15e8419b0, content=<a href='/topic/show?id=cabf914424' target=_blank style='color:#2F92EE;'>#HSCT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9144, encryptionId=cabf914424, topicName=HSCT)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0df016405434, createdName=ms691033630344116, createdTime=Mon Sep 21 08:26:00 CST 2015, time=2015-09-21, status=1, ipAttribution=)]
    2015-09-21 xingcy

    在中国这样的trial比较难吧。

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1828223, encodeId=d0fa1828223e2, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue May 24 12:26:00 CST 2016, time=2016-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1658585, encodeId=b50916585857a, content=<a href='/topic/show?id=4d06914052' target=_blank style='color:#2F92EE;'>#HSC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9140, encryptionId=4d06914052, topicName=HSC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4bd24890262, createdName=sjq035, createdTime=Wed Sep 30 21:26:00 CST 2015, time=2015-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008207, encodeId=4a6c200820e34, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Sat Oct 31 19:26:00 CST 2015, time=2015-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1822031, encodeId=938318220315a, content=<a href='/topic/show?id=ee4b1021266e' target=_blank style='color:#2F92EE;'>#髓系白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102126, encryptionId=ee4b1021266e, topicName=髓系白血病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b79433, createdName=fangcong, createdTime=Fri Sep 25 21:26:00 CST 2015, time=2015-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37608, encodeId=398a3e608cd, content=60岁及以上急性髓系白血病患者耐受性差,治疗较困难, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a1a01625167, createdName=zhouxue1990, createdTime=Thu Oct 01 12:25:00 CST 2015, time=2015-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37093, encodeId=df013e09351, content=在中国这样的trial比较难吧。, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=18bb1631067, createdName=xingcy, createdTime=Mon Sep 21 13:14:00 CST 2015, time=2015-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1317238, encodeId=588f131e2387b, content=<a href='/topic/show?id=74916e0414' target=_blank style='color:#2F92EE;'>#EMA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6704, encryptionId=74916e0414, topicName=EMA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Mon Sep 21 08:26:00 CST 2015, time=2015-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1578419, encodeId=2c5c15e8419b0, content=<a href='/topic/show?id=cabf914424' target=_blank style='color:#2F92EE;'>#HSCT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9144, encryptionId=cabf914424, topicName=HSCT)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0df016405434, createdName=ms691033630344116, createdTime=Mon Sep 21 08:26:00 CST 2015, time=2015-09-21, status=1, ipAttribution=)]
    2015-09-21 fengyi812
  8. [GetPortalCommentsPageByObjectIdResponse(id=1828223, encodeId=d0fa1828223e2, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue May 24 12:26:00 CST 2016, time=2016-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1658585, encodeId=b50916585857a, content=<a href='/topic/show?id=4d06914052' target=_blank style='color:#2F92EE;'>#HSC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9140, encryptionId=4d06914052, topicName=HSC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4bd24890262, createdName=sjq035, createdTime=Wed Sep 30 21:26:00 CST 2015, time=2015-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008207, encodeId=4a6c200820e34, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Sat Oct 31 19:26:00 CST 2015, time=2015-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1822031, encodeId=938318220315a, content=<a href='/topic/show?id=ee4b1021266e' target=_blank style='color:#2F92EE;'>#髓系白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102126, encryptionId=ee4b1021266e, topicName=髓系白血病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b79433, createdName=fangcong, createdTime=Fri Sep 25 21:26:00 CST 2015, time=2015-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37608, encodeId=398a3e608cd, content=60岁及以上急性髓系白血病患者耐受性差,治疗较困难, beContent=null, objectType=article, channel=null, level=null, likeNumber=140, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a1a01625167, createdName=zhouxue1990, createdTime=Thu Oct 01 12:25:00 CST 2015, time=2015-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37093, encodeId=df013e09351, content=在中国这样的trial比较难吧。, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=18bb1631067, createdName=xingcy, createdTime=Mon Sep 21 13:14:00 CST 2015, time=2015-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1317238, encodeId=588f131e2387b, content=<a href='/topic/show?id=74916e0414' target=_blank style='color:#2F92EE;'>#EMA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6704, encryptionId=74916e0414, topicName=EMA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Mon Sep 21 08:26:00 CST 2015, time=2015-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1578419, encodeId=2c5c15e8419b0, content=<a href='/topic/show?id=cabf914424' target=_blank style='color:#2F92EE;'>#HSCT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9144, encryptionId=cabf914424, topicName=HSCT)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0df016405434, createdName=ms691033630344116, createdTime=Mon Sep 21 08:26:00 CST 2015, time=2015-09-21, status=1, ipAttribution=)]
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