Graft-versus-lymphoma effect for aggressive T-cell lymphomas in adults: A study by the Societe Francaise de Greffe de Moelle et de Therapie Cellulaire
Graft-versus-lymphoma effect for aggressive T-cell lymphomas in adults: A study by the Societe Francaise de Greffe de Moelle et de Therapie Cellulaire
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DOI：
10.1200/jco.2007.14.1366
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发表时间：
2008-05-10
影响因子：
45.3
通讯作者：
Michallet, Mauricette
中科院分区：
文献类型：
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作者：
Le Gouill, Steven;Milpied, Noel;Michallet, Mauricette
侵袭性T细胞淋巴瘤（ATCL）占成人非霍奇金淋巴瘤（NHL）的10%~ 15%。ATCL的预后比B细胞淋巴瘤差。患者和方法我们代表Societe Francaise de Greffe de Moelle et de Therapie Cellulaire进行了一项回顾性分析，包括77例接受异基因干细胞移植（alloSCT）的ATCL患者。（ALCL; n = 27），未另行说明的外周T细胞淋巴瘤（PTCL-NOS; n = 27），血管免疫母细胞性T细胞淋巴瘤（AITL; n = 11），肝脾γ/δ淋巴瘤（HSL; n = 3），T细胞颗粒淋巴细胞白血病（T-GLL; n = 1），鼻自然杀伤（NK）/T细胞淋巴瘤（鼻-NK/L; n = 3）或非鼻NK/T细胞淋巴瘤（非鼻-NK/L; n = 2）、肠病型T细胞（n = 1）和人嗜T淋巴细胞病毒（HTLV）-1淋巴瘤（n = 2）。57例患者接受了清髓性预处理方案。供者中70例为人类白细胞抗原（HLA）匹配，60例为相关。31例患者在alloSCT时完全缓解（CR），而26例患者部分缓解（PR）。5年毒性相关死亡率（TRM）为33%（95% CI，24%-46%）。5年总生存率（OS）和无事件生存率（EFS）分别为57%（95% CI，45%至68%）和53%（95% CI，41%至64%）。在多变量分析中，alloSCT时的化疗耐药疾病（稳定、难治或进展性疾病）和严重3 - 4级急性移植物抗宿主病（aGVHD）的发生是OS最强的不良预后因素（分别为P = 0.03和0.03）。疾病状态在移植显着影响5年EFS（P = .003），和HLA不匹配的捐助者增加TRM（P = .04）。ConclusionWe得出结论，alloSCT是一种潜在的有效治疗NK/T淋巴瘤，是值得进一步调查，通过前瞻性临床试验。
PurposeAggressive T-cell lymphomas (ATCLs) represent 10% to 15% of non-Hodgkin's lymphomas (NHLs) in adults. ATCLs show a worse prognosis than B-cell lymphomas.Patients and MethodsOn behalf of the Societe Francaise de Greffe de Moelle et de Therapie Cellulaire, we conducted a retrospective analysis including 77 ATCL patients who underwent allogeneic stem-cell transplantation (alloSCT).ResultsThe different diagnosis included anaplastic large-cell lymphoma (ALCL; n = 27), peripheral T-cell lymphoma not otherwise specified (PTCL-NOS; n = 27), angioimmunoblastic T-cell lymphoma (AITL; n = 11), hepatosplenic gamma/delta lymphoma (HSL; n = 3), T-cell granular lymphocytic leukemia (T-GLL; n = 1), nasal natural killer (NK)/T-cell lymphoma (nasal-NK/L; n = 3) or non-nasal NK/T-cell lymphoma (non-nasal-NK/L; n = 2), enteropathy-type T-cell (n = 1), and human T-lymphotropic virus (HTLV)-1 lymphoma (n = 2). Fifty-seven patients received a myeloablative conditioning regimen. Donors were human leukocyte antigen (HLA)-matched in 70 cases and related in 60 cases. Thirty-one patients were in complete remission (CR) at the time of alloSCT, whereas 26 were in partial response (PR). Five-year toxicity-related mortality (TRM) incidence was 33% (95% CI, 24% to 46%). The 5-year overall survival (OS) and event-free survival (EFS) rates were 57% (95% CI, 45% to 68%) and 53% (95% CI, 41% to 64%), respectively. In multivariate analysis, chemoresistant disease (stable, refractory, or progressing disease) at the time of alloSCT and the occurrence of severe grade 3 to 4 acute graft-versus-host disease (aGVHD) were the strongest adverse prognostic factors for OS (P = .03 and .03, respectively). Disease status at transplantation significantly influenced the 5-year EFS (P = .003), and an HLA-mismatched donor increased TRM (P = .04).ConclusionWe conclude that alloSCT is a potentially efficient therapy for NK/T lymphomas and is worth further investigation through prospective clinical trials.