摘要
目的比较自体造血干细胞移植（auto-HSCT）和异基因造血干细胞移植（allo-HSCT）治疗高危外周T细胞淋巴瘤（PTCL）疗效的差异。方法回顾性分析苏州大学附属第一医院60例接受HSCT治疗的高危PTCL患者临床资料。结果60例PTCL患者均为高危组患者（IVI评分≥3分），接受移植时中位年龄31（12～58）岁。包括PTCL非特指型22例、ALK阴性的间变大细胞淋巴瘤22例、血管免疫母细胞淋巴瘤16例。其中接受auto-HSCT的有39例（63．5％），接受allo-HSCT的有21例（36．5％）。移植前40例完全缓解（CR），2例部分缓解（PR），18例未缓解（NR）。40例CR患者中10例接受allo-HSCT，30例接受auto-HSCT。20例PR＋NR患者中11例接受allo-HSCT，9例接受auto-HSCT。移植后中位随访时间为39（1-96）个月，auto-HSCT和allo-HSCT组的5年无进展生存率分别为61％和60％（P=0．724）。auto-HSCT和allo-HSCT组的5年总生存率分别为62％和61％（P=0．724）。auto-HSCT和allo-HSCT组的5年移植相关死亡率分别为22．7％和41．8％（P=0．250）。截至末次随访时间，auto-HSCT中7例患者复发，allo-HSCT组中2例复发，auto-HSCT和allo-HSCT组的5年累计复发率分别为37．2％和10．1％（P=0．298）。结论高危PTCL患者选择auto-HSCT或allo-HSCT治疗长期生存无明显差异，但allo-HSCT组患者移植前多为NR状态，表明对于NR患者，allo-HSCT效果可能较好。
Objective To evaluate the efficacy of auto-HSCT and allo-HSCT in the treatment of high risk peripheral T cell lymphoma （PTCL）. Methods From July 2007 to July 2014, 60 cases of high risk PTCL were analyzed retrospectively. Results All 60 patients were at high risk group （carried with IPI≥3）, with a median age of 31 （12-58） years old. Of the 60 cases, 22 were PTCL-not otherwise specified （PTCL-NOS）, 22 ALK negative anaplastic large cell lymphoma （ALK-negative ALCL） and 16 angioimmunoblastic T-cell lymphoma （AITL）. Twenty-one patients （21/60） received allo-HSCT, and thirty-nine （39/60） auto-HSCT. Before receiving transplantation, 40/60 patients were in complete remission （CR）, 2/60 patients partial remission （PR） and 18/60 patients not remission （NR）. In the 40 CR patients before transplant, 10 patients received allo-HSCT and 30 patients auto-HSCT, respectively. In the 20 PR/ NR patients before transplant, 11 patients received allo-HSCT and 9 patients auto-HSCT, respectively. After a median follow-up of 39 （range 1-96） months, the K-M analysis showed that the 5-year PFS by auto- HSCT and allo-HSCT were 61% and 60% （P=-0.724）, respectively. The 5-year OS by auto-HSCT and allo- HSCT were 62% and 61% （P=-0.724） , respectively. There were no statistically significant differences between auto-HSCT and allo-HSCT. And the cumulative TRM of auto-HSCT and allo-HSCT were 22.7% and 41.8% （P=0.250） , respectively within 5-years after transplantation. At the end of the last follow-up, 7 and 2 patients relapsed in auto-HSCT and allo-HSCT groups respectively, the 5-year cumulative recurrence rates of auto-HSCT and allo-HSCT transplantation were 37.2% and 10.1% （P=0.298）, respectively. Conclusion There was no signiftcant difference in the long-term survival between auto-HSCT and allo- HSCT for high risk PTCL patients. Outcome by allo-HSCT may be better for NR patients.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2016年第11期952-956,共5页
Chinese Journal of Hematology
基金
江苏省自然科学基金（BK2012610）
江苏省六大人才高峰高层次人才选拨培养资助方案（WSN-020）
关键词
淋巴瘤
T细胞
外周
造血干细胞移植
疗效比较研究
Lymphoma, T-cell, peripheral
Hematopoietic stem cell transplantation
Comparative effectiveness research
