The adjusted International Prognostic Index and β-2-microglobulin predict the outcome after autologous stem cell transplantation in relapsing/refractory peripheral T-cell lymphoma
The adjusted International Prognostic Index and β-2-microglobulin predict the outcome after autologous stem cell transplantation in relapsing/refractory peripheral T-cell lymphoma
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DOI：
10.3324/haematol.11173
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发表时间：
2007-08-01
期刊：
影响因子：
10.1
通讯作者：
Dolores Caballero, Maria
中科院分区：
文献类型：
--
作者：
Rodriguez, Jose;Conde, Eulogio;Dolores Caballero, Maria
背景和目的关于自体干细胞移植(ASCT)用于外周T细胞淋巴瘤(PTCL)抢救治疗的初步资料表明，其结果与侵袭性B细胞淋巴瘤相似。设计与方法1990-2004年间，GELTA-MO数据库登记了123例PTCL患者。移植时的中位年龄为43.5岁；91%的患者对化疗敏感。结果73%的患者完全缓解，11%的患者部分缓解，16%的患者失败。中位随访期61个月，5年总生存率和无进展生存率分别为45%和34%。经调整的国际预后指数(a-IPI)中的一个以上因素和移植时的高β2-微球蛋白被确认为总体和无进展生存的不良预后因素，并允许将人群分成三个不同的风险组。解释和结论我们的数据显示，如果移植时处于化疗敏感的疾病状态，大约三分之一的PTCL患者在抢救环境中可以在ASCT后获得更长的生存时间。α-IPI和β2-微球蛋白水平可预测复发/难治性PTCL ASCT后的预后。
Background and ObjectivesPreliminary data on the use of autologous stem cell transplantation (ASCT) as a salvage therapy for peripheral T-cell lymphoma (PTCL) indicate that the results are similar to those obtained in aggressive B-cell lymphomas. The aim of our study was to analyze outcomes of a large series of patients with PTCL with a prolonged follow-up who received ASCT as salvage therapy.Design and MethodsBetween 1990 and 2004, 123 patients in this situation were registered in the GELTA-MO database. The median age at transplantation was 43.5 years; in 91% of patients the disease was chemosensitive.ResultsSeventy-three percent of the patients achieved complete remission, 11% partial remission and the procedure failed in 16%. At a median follow-up of 61 months, the 5-year overall and progression-free survival rates were 45% and 34%, respectively. The presence of more than one factor of the adjusted International Prognostic Index (a-IPI) and a high beta 2-microglobulin at transplantation were identified as adverse prognostic factors for both overall and progression-free survival and allowed the population to be stratified into three distinct risk groups.Interpretation and ConclusionsOur data show that approximately one third of patients with PTCL in the salvage setting may enjoy prolonged survival following ASCT, provided they are transplanted in a chemosensitive disease state. The a-IPI and beta 2-microglobulin level predict the outcome after ASCT in relapsing/refractory PTCL.