摘要
目的 探讨大剂量化疗联合自体造血干细胞移植（ASCT）治疗侵袭性外周T细胞淋巴瘤（PTCL）的疗效.方法 回顾性分析1997年5月至2013年6月于完全缓解（CR）期接受ASCT治疗的25例侵袭性PTCL患者的临床资料.结果 ①25例患者中男16例,女9例,中位发病年龄30（12～54）岁.病理类型包括PTCL非特指型（PTCL-U） 16例、血管免疫母细胞淋巴瘤（AITL）4例、间变大细胞淋巴瘤（ALCL）3例和肝脾T细胞淋巴瘤（HSTL）2例.临床分期Ⅲ期和Ⅳ期分别为8例和17例;其中合并骨髓侵犯者9例.移植前19例处于CR1期,另6例为CR2期.②2例HSTL均为骨髓侵犯、国际预后指数评分高危患者,联合化疗后获得CR1并行ASCT巩固治疗,但均于移植后12个月内早期复发、死亡.其余23例患者中位随访38（14～110）个月,3年无进展生存（PFS）率和总体生存（OS）率分别为（63.1±10.5）％和（71.8±9.9）％.CR1期（17例）移植者的生存有优于CR2期（6例）移植者的趋势[3年PFS率（74.9±11.0）％对（33.3±19.2）％,P=0.092;3年OS率（80.2±10.4）％对（50.0±20.4）％,P=0.043].无骨髓侵犯者的生存有优于骨髓侵犯者的趋势[3年PFS率（77.9±11.3）％对（40.0±17.4）％,P=0.142;OS率（84.4±10.2）％对（53.3±17.3）％,P=0.076].结论 ASCT改善化疗敏感侵袭性PTCL患者的生存.移植前非CR1状态和淋巴瘤骨髓侵犯可能是影响ASCT疗效的不良预后因素.HSTL患者预后差,ASCT后早期复发率高,需要进一步探索有效的治疗方案.
Objective To investigate the outcomes of autologous stem cell transplantation （ASCT） for patients with aggressive peripheral T-cell lymphoma （PTCLs） in advanced stage.Methods The clinical data of 25 patients in complete remission （CR） with aggressive PTCLs received ASCT from May 1997 to June 2013 were retrospectively analyzed.Results ① Of the 25 cases,16 were unspecified PTCL （PTCL-U）,4 with angioimmunoblastic T cell lymphoma （AITL）,3 with anaplastic large cell lymphoma （ALCL） and 2 with hepatosplenic T cell lymphoma （HSTL）,with a median age of 30（12-54） years old.Ratio of male to female is 16：9.The distribution of stages was 8 cases with stage Ⅲ and 17 patients with stage Ⅳ.Nine patients presented with bone marrow involvement.Before ASCT,18 patients were in CR1 and 7 patients were in CR2.②Two patients with HSTL in stage Ⅳ B and IPI score 4/5 in CR1 relapsed and died within 12 months after ASCT.At a median follow-up of 38 （range 14-110） months,the estimated 3-year probability of PFS and OS for the other 23 patients was （63.1 ± 10.5）％ and （71.8±9.9）％,respectively.The patients in first CR had a better survival than the patients in second CR.The 3-year probability of PFS were （74.9± 11.0）％ vs （33.3± 19.2）％ （P=0.092） and OS were （80.2± 10.4）％ vs （50.0±20.4）％ （P=0.043）,respectively.The 3-year probability of PFS and OS were （40.0± 17.4）％ and （53.3± 17.3）％ in bone marrow involvement patients and the corresponding figure were （77.9± 11.3）％ and （84.4 ± 10.2）％ in non-bone marrow involvement patients.Conclusions ASCT could improve the survival of aggressive PTCLs.Non CR1 status and bone marrow involvement had negative influence on OS in patients with aggressive PTCLs treated by ASCT.The prognosis was very poor in patients with HSTL and satisfactory regimens should be investigated.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2015年第6期455-459,共5页
Chinese Journal of Hematology
基金
科技部重大血液病新药临床评价研究技术平台建设项目（2011ZX09302-007-04）
天津市科技支撑计划（重大科技专项）（12ZCDZSY17600）
关键词
淋巴瘤
T细胞
外周
造血干细胞移植
存活率分析
Lymphoma, T-cell, peripheral
Hematopoietic stem cell transplantation
Survival analysis
