Syngeneic hematopoietic stem-cell transplantation for Non-Hodgkin's lymphoma: A comparison with allogeneic and autologous transplantation - The lymphoma working committee of the International Bone Marrow Transplant Registry and the European Group for Blood and Marrow Transplantation
Syngeneic hematopoietic stem-cell transplantation for Non-Hodgkin's lymphoma: A comparison with allogeneic and autologous transplantation - The lymphoma working committee of the International Bone Marrow Transplant Registry and the European Group for Blood and Marrow Transplantation
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DOI：
10.1200/jco.2003.08.054
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发表时间：
2003-10-15
影响因子：
45.3
通讯作者：
Goldstone, A
中科院分区：
文献类型：
--
作者：
Bierman, PJ;Sweetenham, JW;Goldstone, A
目的：比较同基因、异基因和自体造血干细胞移植治疗非霍奇金淋巴瘤(NHL)的疗效。将这些患者与IBMTR和自体血液和骨髓移植登记中确诊的NHL患者进行比较，这些患者接受了同种异体(T细胞耗尽和T细胞完全)和自体(净化和未净化)移植。结果：在任何组织学上，异基因移植和同种异体移植的复发率没有显著差异。同种异体移植的T细胞耗尽与较高的复发风险无关，但与低级别和中等级别组织学患者总体存活率的提高有关。接受未经净化的自体移植治疗低度非霍奇金淋巴瘤的患者的复发风险是同基因移植受者的五倍(P=0.008)，而接受未经净化的自体移植的患者的复发风险是接受净化的自体移植患者的两倍(P=.0009)。在低级别NHL患者中，与接受未净化自体移植的患者相比，使用净化的患者的无病存活率(P=.003)和总存活率(P=.04)显著提高。结论：这些分析没有发现移植物抗淋巴瘤效应的证据，但确实提供了间接证据，支持肿瘤污染可能导致淋巴瘤复发的假设，并且净化可能有利于接受自体造血干细胞移植治疗低级别NHL的患者。(C)2003年，由美国临床肿瘤学会提供。
Purpose: To compare results of syngeneic, allogeneic, and autologous hematopoietic stem-cell transplantation for non-Hodgkin's lymphoma (NHL).Patients and Methods: The databases of the International Bone Marrow Transplant Registry (IBMTR) and the European Group for Blood and Marrow Transplantation were used to identify 89 NHL patients who received syngeneic transplants. These patients were compared with NHL patients identified from the IBMTR and the Autologous Blood and Marrow Transplant Registry who received allogeneic (T-cell depleted and T-cell replete) and autologous (purged and unpurged) transplants.Results: No significant differences in relapse rates were observed when results of allogeneic transplantation were compared with syngeneic transplantation for any histology. T-cell depletion of allografts was not associated with a higher relapse risk, but was associated with improved overall survival for patients with low-grade and intermediate-grade histology. Patients who received unpurged autografts for low-grade NHL had a five-fold (P = .008) greater risk of relapse than recipients of syngeneic transplants, and recipients of unpurged autografts had a two-fold (P = .0009) greater relapse risk than patients who received purged autografts. Among low-grade NHL patients, the use of purging was associated with significantly better disease-free survival (P = .003) and overall survival (P = .04) when compared with patients who received unpurged autografts.Conclusion: These analyses failed to find evidence of a graft-versus-lymphoma effect, but do provide indirect evidence to support the hypothesis that tumor contamination may contribute to lymphoma relapse, and that purging may be beneficial for patients undergoing autologous hematopoietic stem-cell transplantation for low-grade NHL. (C) 2003 by American Society of Clinical Oncology.