Autologous Transplantation in Follicular Lymphoma with Early Therapy Failure: A National LymphoCare Study and Center for International Blood and Marrow Transplant Research Analysis
Autologous Transplantation in Follicular Lymphoma with Early Therapy Failure: A National LymphoCare Study and Center for International Blood and Marrow Transplant Research Analysis
复制标题
DOI：
10.1016/j.bbmt.2017.12.771
复制
发表时间：
2018-06-01
影响因子：
4.3
通讯作者：
Hamadani, Mehdi
中科院分区：
文献类型：
--
作者：
Casulo, Carla;Friedberg, Jonathan W.;Hamadani, Mehdi
滤泡性淋巴瘤（FL）患者在一线化疗免疫治疗的2年内经历早期治疗失败（ETF），总生存期（OS）较差。我们分析了来自国际血液和骨髓移植研究中心（CIBMTR）和国家造血关怀研究（NLCS）的数据，以确定自体造血细胞移植（autoHCT）是否可以改善这种高危FL亚组的结局。ETF定义为一线化疗免疫治疗后未能达到至少部分缓解或一线化疗免疫治疗2年内淋巴瘤进展。我们确定了两组：非autoHCT队列（来自NLCS的未接受autoHCT的ETF患者）和autoHCT队列（接受autoHCT的CIBMTR ETF患者）。所有患者均接受基于利妥昔单抗的化疗作为一线治疗;确定并分析了174例非autoHCT患者和175例autoHCT患者。两组之间的5年OS没有差异（分别为60%和67%; P = 0.16）。一项计划的亚组分析显示，治疗失败后不久接受autoHCT的ETF患者（
Patients with follicular lymphoma (FL) experiencing early therapy failure (ETF) within 2 years of frontline chemoimmunotherapy have poor overall survival (OS). We analyzed data from the Center for International Blood and Marrow Transplant Research (CIBMTR) and the National LymphoCare Study (NLCS) to determine whether autologous hematopoietic cell transplant (autoHCT) can improve outcomes in this high-risk FL subgroup. ETF was defined as failure to achieve at least partial response after frontline chemoimmunotherapy or lymphoma progression within 2 years of frontline chemoimmunotherapy. We identified 2 groups: the nonautoHCT cohort (patients from the NLCS with ETF not undergoing autoHCT) and the autoHCT cohort (CIBMTR patients with ETF undergoing autoHCT). All patients received rituximab-based chemotherapy as frontline treatment; 174 non-autoHCT patients and 175 autoHCT patients were identified and analyzed. There was no difference in 5-year OS between the 2 groups (60% versus 67%, respectively; P = .16). A planned subgroup analysis showed that patients with ETF receiving autoHCT soon after treatment failure (