Does follicularity in large cell lymphoma predict outcome after autologous stem cell transplantation?
Does follicularity in large cell lymphoma predict outcome after autologous stem cell transplantation?
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大细胞淋巴瘤的滤泡性是否可以预测自体干细胞移植后的结果？
DOI：
10.1016/j.bbmt.2005.12.040
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发表时间：
2006
期刊：
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作者：
Krishnan,Amrita;Nademanee,Auayporn;Fung,Henry;Angelopoulou,Maria;Molina,Arturo;Gaal,Karl;Dagis,Andrew;Palmer,Joycelynne;Alvarnas,Joseph;Slovak,Marilyn;Kogut,Neil;Popplewell,Leslie;Rodriguez,Roberto;Schriber,Jeffrey;Wang,Sean;
本研究的目的是评估大细胞淋巴瘤的滤泡组织学是否影响自体干细胞移植（ASCT）后的治疗结果。滤泡性大细胞淋巴瘤（FLCL）的自然史是否类似于具有治愈潜力的弥漫性大细胞淋巴瘤（DLCL）或更类似于密集化疗后晚期复发模式的惰性滤泡性淋巴瘤，这仍然是一个有争议的领域。尽管ASCT是复发性DLCL患者的潜在治愈性治疗，但该方法在FLCL患者中的有效性尚不清楚。我们对在City of Hope综合癌症中心接受ASCT的332例大细胞淋巴瘤患者进行了回顾性分析。中位随访时间为31个月，FLCL和DLCL患者的预计10年总生存期和无病生存期相似。对预后因素的分析表明，尽管年龄、化疗难治性和ASCT时的疾病状态可预测总生存期/无病生存期，但卵泡发育并不影响预后。此外，DLCL和FLCL患者的生存曲线中相似的平台表明FLCL的行为与DLCL相似，并且FLCL可能通过ASCT治愈。
The purpose of this study was to evaluate whether follicular histology in large cell lymphoma influences treatment outcomes after autologous stem cell transplantation (ASCT). It remains an area of controversy whether the natural history of follicular large cell lymphoma (FLCL) is akin to diffuse large cell lymphoma (DLCL) with curative potential or is more similar to indolent follicular lymphomas with a pattern of late relapses after intensive chemotherapy. Although ASCT is a potentially curative treatment for patients with recurrent DLCL, the effectiveness of this approach in patients with FLCL is unclear. We undertook a retrospective analysis of 332 patients with large cell lymphoma who underwent ASCT at the City of Hope Comprehensive Cancer Center. With a median follow-up of 31 months, the projected 10-year overall survival and disease-free survival were similar between patients with FLCL and DLCL. Analysis of prognostic factors demonstrated that although age, chemotherapy refractoriness, and disease status at the time of ASCT were predictive of overall survival/disease-free survival, follicularity did not influence the outcome. Furthermore, the similar plateau in the survival curve for the DLCL and FLCL patients suggests that the behavior of FLCL is similar to that of DLCL and that FLCL is potentially curable with ASCT.