Allogeneic transplantation in lymphoma: current status
Allogeneic transplantation in lymphoma: current status
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DOI：
10.3324/haematol.11185
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发表时间：
2007-10-31
期刊：
影响因子：
10.1
通讯作者：
Sureda, Anna
中科院分区：
文献类型：
--
作者：
Schmitz, Norbert;Dreger, Peter;Sureda, Anna
同种异体造血干细胞移植（allo-SCT）越来越多地用于治疗淋巴瘤患者。我们描述了目前同种异体sct治疗霍奇金病、惰性淋巴瘤（包括瓦尔登斯特罗姆病）和侵袭性淋巴瘤（包括套细胞淋巴瘤和成熟t细胞淋巴瘤）患者的结果。Graft-vs。-淋巴瘤（GvL）效应存在于大多数实体中，这可以从同种异体细胞移植后普遍较低的复发率和供体淋巴细胞输注的结果中得到证明。缓慢增殖的疾病，如慢性淋巴细胞白血病、惰性淋巴瘤和一些t细胞淋巴瘤对同种异体t细胞的作用特别敏感，而霍奇金病和侵袭性淋巴瘤患者可能需要在同种异体sct之前进行有力的减容，以达到最佳效果。虽然低强度调节降低了大多数移植相关的死亡率，并提高了一些亚实体的生存率，但霍奇金病和侵袭性b细胞淋巴瘤患者以及大量预处理和难治性淋巴瘤患者的复发率仍然很高，无疑需要进一步改善。为了进一步阐明同种异体细胞移植在淋巴瘤中的作用，有必要在明确的实体中进行大规模的前瞻性研究。
Allogeneic transplantation of hematopoietic stem cells (allo-SCT) is being increasingly used to treat patients with lymphoma. We describe current results of allo-SCT in patients with Hodgkin's disease, indolent lymphoma including Waldenstrom's disease, and aggressive lymphoma including mantle cell lymphoma and mature T-cell lymphomas. A Graft-vs.-Lymphoma (GvL) effect is present in most entities as evidenced by the generally lower relapse rates after allo-SCT and the results of donor lymphocyte infusions. Slowly proliferating diseases like chronic lymphocytic leukemia, indolent lymphomas, and some T-cell lymphomas are particularly sensitive to the effects of allogeneic T-cells while patients with Hodgkin's disease and aggressive lymphoma may need vigorous debulking before allo-SCT to achieve optimal results. Although reduced-intensity conditioning has lowered transplant-related mortality in most and improved survival in some sub-entities, relapse rates in patients with Hodgkin's disease and aggressive B-cell lymphomas, as well as in patients with heavily pre-treated and refractory lymphoma, remain high and further improvement is undoubtedly needed. Large prospective studies in well-defined entities are necessary to further clarify the role of allo-SCT in lymphoma.