Impact of high-dose chemotherapy on peripheral T-cell lymphomas
Impact of high-dose chemotherapy on peripheral T-cell lymphomas
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DOI：
10.1200/jco.2001.19.17.3766
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发表时间：
2001-09-01
影响因子：
45.3
通讯作者：
Khouri, IF
中科院分区：
文献类型：
--
作者：
Rodriguez, J;Munsell, M;Khouri, IF
目的：评估高剂量化疗 (HDCT) 和自体或异体造血移植对于既往常规化疗后疾病复发的外周 T 细胞淋巴瘤 (PTCL) 患者的疗效。 患者和方法：我们对 1989 年至 1998 年间来自德克萨斯大学 M.D. 安德森癌症中心的 36 名 PTCL 患者进行了回顾性分析，这些患者接受 HDCT 和自体或异体造血移植治疗结果：总共研究了 36 名患者（29 名接受自体移植，7 名接受同种异体移植）。 3 年总生存率为 36%（95% 置信区间 [CI]，23% 至 59%），无进展生存（PFS）率为 28%（95% CI，16% 至 49%）。移植前血清乳酸脱氢酶水平是生存率和 PFS 率最重要的预后因素 (P < .001)。移植前国际预后指数评分小于或等于 1 表明存活率较高 (P = .036)，但 PFS 率并未改善。中位随访时间为 43 个月（范围为 13 至 126 个月），结果显示 13 名患者 (36%) 仍然存活，没有任何疾病证据。结论：我们的结果与已发表的 B 细胞非霍奇金淋巴瘤 (NHL) 患者 HDCT 数据相当，尽管已知 PTCL 患者与 B 细胞 NHL 患者相比预后较差。考虑到 PTCL 患者传统化疗的惨淡结果，这些数据提出了这样的假设：NHL 中 T 细胞表型分析的不良预后影响可能可以通过一线 HDCT 和移植来克服。
Purpose : To evaluate the outcome of high-dose chemotherapy (HDCT) and autologous or allogeneic hematopoietic transplantation in patients with peripheral T-cell lymphoma (PTCL) who experienced disease recurrence after prior conventional chemotherapy.Patients and Methods: We performed a retrospective analysis of 36 PTCL patients from the University of Texas M.D. Anderson Cancer Center treated between 1989 and 1998 with HDCT and autologous or allogeneic hematopoietic transplantation.Results: A total of 36 patients were studied (29 received autologous transplantation, and seven received allogeneic transplantation). The overall survival rate at 3 years was 36% (95% confidence interval [CI], 23% to 59%), and the progression-free survival (PFS) rate was 28% (95% CI, 16% to 49%). The pretransplant serum lactate dehydrogenase level was the most important prognostic factor for both survival and PFS rates (P < .001). A Pretransplant International Prognostic Index score of less than or equal to 1 indicated a superior survival rate (P = .036) but not an improved PFS rate. A median follow-up of 43 months (range, 13 to 126 months) showed 13 patients (36%) were still alive with no evidence of disease.Conclusion: Our results are comparable to the published data on HDCT in B-cell non-Hodgkin's lymphoma (NHL) patients despite the fact that patients with PTCL are known to have a worse outcome compared with B-cell NHL patients. Considering the dismal outcome of conventional chemotherapy in PTCL patients, these data suggest the hypothesis that the poor prognostic implication of T-cell phenotyping in NHL might be overcome by frontline HDCT and transplantation.