Outcome and Prospective Factor Analysis of High-dose Therapy Combined with Autologous Peripheral Blood Stem Cell Transplantation in Patients with Peripheral T-cell Lymphomas.
Outcome and Prospective Factor Analysis of High-dose Therapy Combined with Autologous Peripheral Blood Stem Cell Transplantation in Patients with Peripheral T-cell Lymphomas.
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大剂量治疗联合自体外周血干细胞移植治疗外周T细胞淋巴瘤的疗效及前瞻性因素分析
DOI：
10.7150/ijms.23067
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发表时间：
2018
影响因子：
3.6
通讯作者：
Zhu J
中科院分区：
文献类型：
--
作者：
Wu M;Wang X;Xie Y;Liu W;Zhang C;Ping L;Ying Z;Deng L;Zheng W;Lin N;Tu M;Song Y;Zhu J
背景资料：对于外周T细胞淋巴瘤（PTCL）患者，由于常规化疗缺乏疗效，高剂量治疗联合自体外周血干细胞移植（HDT/ASCT）已成为替代治疗选择。然而，并非所有PTCL都能从HDT/ASCT中获益。本研究的目的是评估大剂量治疗联合自体外周血干细胞移植（HDT/ASCT）在中国外周T细胞淋巴瘤（PTCL）患者中的价值，以确定最适合接受HDT/ASCT的队列。研究方法：回顾性分析了2001年1月至2016年8月在北京大学肿瘤医院接受HDT/ASCT的79例PTCL患者。结果如下：中位随访时间为23.6个月，整个队列的2年无进展生存期（PFS）和2年总生存期（OS）分别为75.2%和83.6%。首次完全缓解（CR 1）患者（2年PFS为85.8%，2年OS为94.2%）的生存率优于其他患者（上级）。与首次部分缓解（PR 1）患者相比，第二次完全缓解（CR 2）患者的生存率无优势（2年PFS：43. 8% vs. 76. 2%，p= 0. 128; 2年OS：72. 9% vs. 77. 1%，p= 0. 842）。在多变量分析中，HDT/ASCT前的应答（p=0.001）和HDT/ASCT前的LDH（p=0.047）对PFS具有高度预测性，而没有任何因素可以独立预测OS。亚组分析显示，HDT/ASCT可以改善血管免疫母细胞性T细胞淋巴瘤（AITL）患者的生存率，尤其是在化疗敏感的患者中。接受HDT/ASCT伴CR 1的自然杀伤/T细胞淋巴瘤（NKTCL）患者的生存率也从HDT/ASCT中获益，而近90%的非CR 1患者在HDT/ASCT后出现骨髓受累。结论：一线治疗后达到完全缓解的患者，尤其是AITL和NKTCL，应强烈建议接受HDT/ASCT。未来的前瞻性试验是必要的。
Background: For peripheral T-cell lymphomas (PTCLs) patients, high-dose therapy combined with autologous peripheral blood stem cell transplantation (HDT/ASCT) has been an alternative treatment option, due to the lack of efficacy from conventional chemotherapy. While not all PTCLs could have benefit in survival from HDT/ASCT. The aim of this study was to evaluate the value of high-dose therapy combined with autologous peripheral blood stem cell transplantation (HDT/ASCT) in Chinese patients with Peripheral T-cell Lymphomas (PTCLs), in order to determine the cohort most suitable to receive HDT/ASCT. Methods: A total of 79 patients with PTCLs who received HDT/ASCT in Peking University Cancer Hospital & Institute from January 2001 to august 2016 were retrospectively analyzed. Results: At a median follow-up time of 23.6 months, the 2-year progression-free survival (PFS) and 2-year overall survival (OS) of the entire cohort were 75.2% and 83.6% respectively. Patients with first complete remission (CR1) (2-year PFS 85.8%, 2-year OS 94.2%) were superior to others in survival. Patients with second complete remission (CR2) had no advantage in survival compared with those with first partial remission (PR1) (2-year PFS: 43.8% vs. 76.2%, p=0.128; 2-year OS: 72.9% vs. 77.1%, p=0.842). In multivariate analysis, response before HDT/ASCT (p=0.001) and LDH before HDT/ASCT (p=0.047) were highly predictive for PFS, while no factors could independently predict OS. Subgroup analysis revealed that HDT/ASCT could improve the survival of patients with angioimmunoblastic T-cell lymphoma (AITL), especially in patients with chemosensitivity. Patients with natural killer / T-cell lymphoma (NKTCL) who received HDT/ASCT with CR1 also had benefit in survival from HDT/ASCT, while nearly 90% of non-CR1 patients appeared bone marrow involvement after HDT/ASCT. Conclusion: Patients who achieved complete remission after first-line therapy, especially with AITL and NKTCL, should strongly be recommended to receive HDT/ASCT. The future prospective trial is warranted.
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影响因子：
4.3
作者：
Chen, Andy I.;McMillan, Alex;Neprin, Robert S.;Horning, Sandra J.;Laport, Ginna G.
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Laport, Ginna G.
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作者：
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通讯作者：
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