Outcomes of myeloablative peripheral blood stem cell transplantation for non-complete remission patients with relapsed/refractory peripheral T cell lymphomas
Outcomes of myeloablative peripheral blood stem cell transplantation for non-complete remission patients with relapsed/refractory peripheral T cell lymphomas
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DOI：
10.1007/s00277-018-3559-3
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发表时间：
2019-05-01
影响因子：
3.5
通讯作者：
Huang, Wenrong
中科院分区：
文献类型：
--
作者：
Gu, Zhenyang;Wang, Lu;Huang, Wenrong
关于清髓性异基因外周血干细胞移植（allo-PBSCT）治疗复发性/难治性外周T细胞淋巴瘤（PTCL）非完全缓解（non-CR）患者的疗效信息有限。我们对2008年1月至2016年6月期间接受清髓性allo-PBSCT的21例连续非CR复发/难治性PTCL患者进行了回顾性研究。存活者的中位随访时间为46.5个月（范围：14-105个月）。估计的3年复发率为24%（95% CI，9 - 43%）。3年非复发死亡率为24%（95% CI，9 - 44%）。总体而言，估计的3年总生存率为47%（95% CI，25 - 66%）。估计3年无进展生存率为46%（95%CI，24 - 66%）。具体来说，8名患者在allo-PBSCT后3个月的首次评估时未能达到CR，并接受了免疫抑制治疗。5例患者还接受了供体淋巴细胞输注。5例（5/8，62.5%）患者随后对这些干预措施有反应（完全= 4，部分= 1）。总的来说，10例患者在我们的最后一次随访中存活，9例患者在没有进一步治疗的情况下实现了持久CR。这10例存活患者中有5例（50%）发生了慢性移植物抗宿主病（GVHD）。我们有利的临床结果表明，清髓性allo-PBSCT是复发性/难治性PTCL非CR患者的有效治疗选择。免疫干预后的持续CR和存活患者中慢性GVHD的高患病率提供了移植物抗T细胞淋巴瘤效应的证据。
There was limited information about the efficacy of myeloablative allogeneic peripheral blood stem cell transplantation (allo-PBSCT) in non-complete remission (non-CR) patients with relapsed/refractory peripheral T cell lymphomas (PTCLs). We conducted a retrospective study of 21 consecutive non-CR patients with relapsed/refractory PTCLs who received myeloablative allo-PBSCT between January 2008 and June 2016. The median follow-up of survivors was 46.5 months (range, 14-105 months). The estimated 3-year relapse rate was 24% (95% CI, 9 to 43%). The 3-year non-relapsed mortality rate was 24% (95% CI, 9 to 44%). Overall, the estimated 3-year overall survival was 47% (95% CI, 25 to 66%). And the estimated 3-year progression-free survival was 46% (95% CI, 24 to 66%). Specifically, eight patients failed to achieve a CR at the first evaluation 3 months after allo-PBSCT and received withdraw of immunosuppression. Five patients also received donor lymphocytes infusions. Five (5/8, 62.5%) patients responded subsequently to these interventions (complete = 4, partial = 1). Overall, ten patients were alive at our last follow-ups, and durable CR were achieved in nine patients without further therapy. Five (50%) of these ten alive patients experienced chronic graft-versus-host disease (GVHD). Our favorable clinical outcomes suggested myeloablative allo-PBSCT was a valid therapeutic option for non-CR patients with relapsed/refractory PTCLs. The sustained CR after immunotherapeutic intervention and high prevalence of chronic GVHD in alive patients provided evidence of graft versus T cell lymphoma effects.