Prolonged survival of patients with angioimmunoblastic T-cell lymphoma after high-dose chemotherapy and autologous stem cell transplantation.: The GELTAMO experience
Prolonged survival of patients with angioimmunoblastic T-cell lymphoma after high-dose chemotherapy and autologous stem cell transplantation.: The GELTAMO experience
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DOI：
10.1111/j.1600-0609.2007.00815.x
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发表时间：
2007-04-01
影响因子：
3.1
通讯作者：
Caballero, Maria Dolores
中科院分区：
文献类型：
--
作者：
Rodriguez, Jose;Conde, Eulogio;Caballero, Maria Dolores
目的：血管免疫母细胞t细胞淋巴瘤（AIL）是一种罕见的淋巴瘤，预后差，无标准治疗方法。在这里，我们报告了1992年至2004年间GELTAMO合作组中19例接受大剂量化疗和自体干细胞移植（HDC/ASCT）治疗的患者的经验。方法：移植时的中位年龄为46岁。15例患者接受一线治疗，4例患者接受挽救治疗。大多数患者接受外周干细胞（90%）联合BEAM或BEAC作为调理方案（79%）。结果：79%的患者完全缓解，5%的患者部分缓解，16%的患者手术失败。中位随访25个月后，8例患者死亡（7例为进展性疾病和继发性肿瘤），而精算总生存率和3年无进展生存率分别为60%和55%。与预后不良相关的预后因素包括骨髓受累、难治性疾病状态下的移植，归因于年龄调整的国际预后指数、移植前周围t细胞淋巴瘤（PTCL）评分或PTCL预后指数的多个因素。结论：在诊断或复发时表现出不利预后因素的AIL患者中，超过一半的患者在接受HDC/ASCT治疗3年后有望存活且无病。在难治性疾病状态下进行移植的患者不能从该手术中获益。
Objectives: Angioimmunoblastic T-cell lymphoma (AIL) is a rare lymphoma with a poor prognosis and no standard treatment. Here, we report our experiences with 19 patients treated with high-dose chemotherapy and autologous stem cell transplantation (HDC/ASCT) within the GELTAMO co-operative group between 1992 and 2004. Methods: The median age at transplantation was 46 yr. Fifteen patients underwent the procedure as front-line therapy and four patients as salvage therapy. Most patients received peripheral stem cells (90%) coupled with BEAM or BEAC as conditioning regimen (79%). Results: A 79% of patients achieved complete response, 5% partial response and 16% failed the procedure. After a median follow-up of 25 months, eight patients died (seven of progressive disease and secondary neoplasia), while actuarial overall survival and progression-free survival at 3 yr was 60% and 55%. Prognostic factors associated with a poor outcome included bone marrow involvement, transplantation in refractory disease state, attributing more than one factor of the age-adjusted-International Prognostic Index, Pretransplant peripheral T-cell lymphoma (PTCL) Score or Prognostic Index for PTCL. Conclusions: More than half of the patients with AIL that display unfavourable prognostic factors at diagnosis or relapse would be expected to be alive and disease-free after 3 yr when treated with HDC/ASCT. Patients who are transplanted in a refractory disease state do not benefit from this procedure.