Tandem autologous hematopoietic stem cell transplantation for treatment of adult T-cell lymphoblastic lymphoma: a multiple center prospective study in China.
Tandem autologous hematopoietic stem cell transplantation for treatment of adult T-cell lymphoblastic lymphoma: a multiple center prospective study in China.
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串联自体造血干细胞移植治疗成人T细胞淋巴母细胞淋巴瘤：中国多中心前瞻性研究。
DOI：
10.3324/haematol.2019.226985
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发表时间：
2021-01-01
期刊：
影响因子：
10.1
通讯作者：
Zhang X
中科院分区：
文献类型：
--
作者：
Liu Y;Rao J;Li J;Wen Q;Wang S;Lou S;Yang T;Li B;Gao L;Zhang C;Kong P;Gao L;Wang M;Zhu L;Xiang X;Zhou S;Liu X;Peng X;Zhong J;Zhang X
T细胞淋巴母细胞性淋巴瘤(T-LBL)是一种高度侵袭性的淋巴瘤，临床预后差，没有标准的治疗方案。在这项研究中，我们评估了串联自体造血干细胞移植(Auto-HSCT)治疗成人T-LBL的安全性和有效性，并评估了影响预后的因素。入选181例初诊成人T-LBL患者：89例单纯化疗，46例单用自体造血干细胞移植，46例接受串联自体造血干细胞移植。中位随访时间为37个月，串联自体造血干细胞移植组的3年进展/复发率显著低于单一自体造血干细胞移植组和化疗组(分别为26.5%、53.1%和54.8%)。串联自体造血干细胞移植组的3年无进展生存率(PFS)和总生存率(OS)(73.5%和76.3%)明显高于单纯自体造血干细胞移植组(46.9%和58.3%)和化疗组(45.1%和57.1%)。在串联自体造血干细胞移植组中，年龄和第一次移植后的疾病状况影响OS和PFS。多变量分析证实，首次移植后的疾病状态是接受Tandem-HSCT治疗的患者唯一独立的预后因素。此外，初始CD8+CD28+/CD8+CD28-T细胞比率在预测疾病状态方面的诊断模型也被发现具有重要意义。综上所述，串联式AUTO-HSCT可被认为是成人T-LBL患者的最佳策略。(研究注册号：ChiCTR-ONN-16008480)。
T-cell lymphoblastic lymphoma (T-LBL) is a highly aggressive form of lymphoma with poor clinical outcomes and no standard treatment regimen. In this study, we assessed the safety and efficacy of tandem autologous hematopoietic stem cell transplantation (auto-HSCT) for adult T-LBL and evaluated prognostic factors affecting survival. A total of 181 newly-diagnosed adult T-LBL patients were enrolled: 89 patients were treated with chemotherapy alone, 46 were allocated to the single auto-HSCT group, 46 were treated with tandem auto-HSCT. Median follow-up time was 37 months; the 3-year progression/relapse rate of the tandem auto- HSCT group was significantly lower than that of the single auto-HSCT and chemotherapy groups (26.5% vs. 53.1% and 54.8%). The 3-year progression- free survival (PFS) and overall survival (OS) rates of the tandem auto- HSCT group (73.5% and 76.3%) were significantly higher than those of the single auto-HSCT group (46.9% and 58.3%) and the chemotherapy group (45.1% and 57.1%). In the tandem auto-HSCT group, age and disease status after the first transplant impacted OS and PFS. Multivariate analysis identified that disease status after the first transplant was the only independent prognostic factor for patients treated with tandem-HSCT. In addition, diagnostic models of the initial CD8+CD28+/CD8+CD28– T-cell ratio in predicting the disease status were found to be significant. Taken together, tandem auto- HSCT can be considered an optimal strategy for adult T-LBL patients. (Study registered at: ChiCTR-ONN-16008480).
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影响因子：
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作者：
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