Reduced-intensity allogeneic transplantation provides high event-free and overall survival in patients with advanced indolent B cell malignancies: CALGB 109901.
Reduced-intensity allogeneic transplantation provides high event-free and overall survival in patients with advanced indolent B cell malignancies: CALGB 109901.
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低强度同种异体移植可为晚期惰性 B 细胞恶性肿瘤患者提供较高的无事件生存率和总体生存率：CALGB 109901。
DOI：
10.1016/j.bbmt.2011.01.016
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
CancerandLeukemiaGroupB
中科院分区：
文献类型：
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作者：
Shea,Thomas;Johnson,Jeffrey;Westervelt,Peter;Farag,Sherif;McCarty,John;Bashey,Asad;Isola,Luis;Baxter-Lowe,Lee-Anne;Kelly,Michael;Owzar,Kouros;Linker,Charles;CancerandLeukemiaGroupB
癌症和白血病组B进行了一项II期研究，以评价降低强度预处理方案联合同种异体移植治疗复发性低级别B细胞恶性肿瘤患者的安全性和有效性。年龄超过18岁、诊断为复发性、化疗敏感性疾病的患者接受匹配的同胞供体移植，并接受环磷酰胺（1 g/m2/天× 3）和磷酸氟达拉滨（25 mg/m2/天× 5）预处理。移植物抗宿主预防包括环孢素或他克莫司加低剂量甲氨蝶呤。入组了44例可评价患者，中位年龄为53岁，中位既往接受过2种治疗方案。16例患者患有滤泡性非霍奇金淋巴瘤，28例患者具有组织学类型，包括7例惰性B细胞淋巴瘤，4例套细胞，15例慢性淋巴细胞白血病（CLL）和2例幼淋巴细胞白血病（PLL）患者。6个月治疗相关死亡率（TRM）为2.4%，3年TRM为9%。三年无事件和总生存率分别为0.75和0.81滤泡患者，0.59和0.71的CLL/PLL患者，0.55和0.64的其他组织学。II-IV级急性移植物抗宿主病（GVHD）的发生率为29%，广泛慢性GVHD的发生率为18%。本报告表明，异基因同胞移植与降低强度的预处理方案是安全和有效的晚期惰性B细胞恶性肿瘤患者参加了合作组的研究。
Cancer and Leukemia Group B conducted a phase II study to evaluate the safety and efficacy of a reduced-intensity conditioning regimen with allogeneic transplantation to treat patients with recurrent low-grade B cell malignancies. Patients over age 18 with a diagnosis of relapsed, chemotherapy-sensitive disease underwent transplantation with a matched sibling donor, and conditioning with cyclophosphamide (1 g/m2/day × 3) and fludarabine phosphate (25 mg/m2/day × 5). Graft-versus-host prophylaxis included cyclosporine or tacrolimus plus low-dose methotrexate. Forty-four evaluable patients with a median age of 53 and median of 2 prior regimens were accrued. Sixteen patients had follicular non-Hodgkin lymphoma and 28 had histologies including 7 indolent B cell lymphomas, 4 mantle cell, 15 chronic lymphocytic leukemia (CLL), and 2 prolymphocytic leukemia (PLL) patients. The 6-month treatment-related mortality (TRM) was 2.4% and 3-year TRM was 9%. Three-year event-free and overall survival were 0.75 and 0.81 for the follicular patients, 0.59 and 0.71 for the CLL/PLL patients, and 0.55 and 0.64 for the other histologies. The incidence of grade II-IV acute graft-versus-host disease (GVHD) was 29%, and extensive chronic GVHD was 18%. This report demonstrates that allogeneic sibling transplantation with a reduced-intensity conditioning regimen is safe and efficacious for patients with advanced indolent B cell malignancies enrolled on a Cooperative Group study.