A comparison of HLA-identical sibling allogeneic versus autologous transplantation for diffuse large B cell lymphoma: a report from the CIBMTR.
A comparison of HLA-identical sibling allogeneic versus autologous transplantation for diffuse large B cell lymphoma: a report from the CIBMTR.
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DOI：
10.1016/j.bbmt.2009.08.011
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发表时间：
2010-01
影响因子：
4.3
通讯作者：
Hari, Parameswaran N.
中科院分区：
文献类型：
--
作者：
Lazarus, Hillard M.;Zhang, Mei-Jie;Carreras, Jeanette;Hayes-Lattin, Brandon M.;Ataergin, Asli Selmin;Bitran, Jacob D.;Bolwell, Brian J.;Freytes, Cesar O.;Gale, Robert Peter;Goldstein, Steven C.;Hale, Gregory A.;Inwards, David J.;Klumpp, Thomas R.;Marks, David I.;Maziarz, Richard T.;McCarthy, Philip L.;Pavlovsky, Santiago;Rizzo, J. Douglas;Shea, Thomas C.;Schouten, Harry C.;Slavin, Shimon;Winter, Jane N.;van Besien, Koen;Vose, Julie M.;Hari, Parameswaran N.
我们比较了1995-2003年间向CIBMTR报告的916例年龄≥ 18岁的弥漫性大B细胞淋巴瘤（DLBCL）患者接受首次自体（n=837）或清髓性异基因造血细胞移植（HCT）（n=79）的结局。同种异体HCT的中位随访时间为81个月，自体HCT为60个月。异基因HCT受者更可能具有高风险疾病特征，包括更高的分期、更早的化疗方案和耐药疾病。同种异体HCT与较高的1年治疗相关死亡率（TRM）（RR 4.88，95% CI，3.21-7.40，p<0.001）、治疗失败（RR 2.06，95% CI，1.54-2.75，p<0.001）和死亡率（RR 2.75，95% CI，2.03-3.72，p<0.001）相关。两组的疾病进展风险相似（RR 1.12，95% CI，0.73-1.72，p=0.59）。事实上，对于1年生存者，未观察到TRM、进展、无进展或总生存期的显著差异。TRM和死亡率的风险增加与年龄较大（>50岁），较低的性能评分，耐药性和移植年份较早有关。在主要为高风险DLBCL患者的队列中，与接受自体HCT的低风险患者相比，前期清髓性同种异体HCT虽然与早期死亡率增加相关，但与疾病进展风险相似。
We compared outcomes of 916 diffuse large B cell lymphoma (DLBCL) patients age ≥ 18 years undergoing first autologous (n=837) or myeloablative allogeneic hematopoietic cell transplant (HCT) (n=79) between 1995–2003 reported to the CIBMTR. Median follow-up was 81 months for allogeneic HCT vs. 60 months for autologous. Allogeneic HCT recipients were more likely to have high risk disease features including higher stage, more prior chemotherapy regimens and resistant disease. Allogeneic HCT was associated with a higher 1 year treatment-related mortality (TRM) (RR 4.88, 95% CI, 3.21–7.40, p<0.001), treatment failure (RR 2.06, 95% CI, 1.54–2.75, p<0.001) and mortality (RR 2.75, 95% CI, 2.03–3.72, p<0.001). Risk of disease progression was similar in the 2 groups (RR 1.12, 95% CI, 0.73–1.72, p=0.59). In fact, for 1 year survivors, no significant differences were observed for TRM, progression, progression-free or overall survival. Increased risks of TRM and mortality were associated with older age (>50 years), lower performance score, chemoresistance and earlier year of transplant. In a cohort of mainly high risk DLBCL patients, upfront myeloablative allogeneic HCT while associated with increased early mortality was associated with a similar risk of disease progression compared to lower risk patients receiving autologous HCT.
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影响因子：
4.3
作者：
Lerner, Rachel E.;Thomas, William;Burns, Linda J.
通讯作者：
Burns, Linda J.
影响因子：
4.8
作者：
Glaspy, JA
通讯作者：
Glaspy, JA
影响因子：
51.1
作者：
Pfreundschuh, Michael;Trumper, Lorenz;Loeffler, Markus
通讯作者：
Loeffler, Markus
影响因子：
45.3
作者：
Bierman, PJ;Sweetenham, JW;Goldstone, A
通讯作者：
Goldstone, A
影响因子：
45.3
作者：
Krishnan, Amrita;Nademanee, Auayporn;Forman, Stephen J.
通讯作者：
Forman, Stephen J.