Allogeneic Stem Cell Transplantation Is Able to Induce Long-Term Remissions in Angioimmunoblastic T-Cell Lymphoma: A Retrospective Study From the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation
Allogeneic Stem Cell Transplantation Is Able to Induce Long-Term Remissions in Angioimmunoblastic T-Cell Lymphoma: A Retrospective Study From the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation
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DOI：
10.1200/jco.2008.20.4628
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发表时间：
2009-08-20
影响因子：
45.3
通讯作者：
Schmitz, Norbert
中科院分区：
文献类型：
--
作者：
Kyriakou, Charalampia;Canals, Carmen;Schmitz, Norbert
目的分析1998年1月至2005年12月接受异基因干细胞移植(AllSCT)治疗的血管免疫母细胞性T细胞淋巴瘤(AITL)患者的无复发死亡率(NRM)、复发率(RR)、无进展生存期(PFS)和总生存期(OS)。中位年龄为48岁(范围23-68岁)，34名患者在异基因SCT前接受了两种化疗方案，11名患者之前接受过自体干细胞移植治疗失败。25名患者接受了清髓异基因SCT，20名患者接受了低强度异基因SCT。26名患者的捐献者是人类白细胞抗原相合的兄弟姐妹。结果3、6、12个月NRM的累积发生率分别为18%、22%、25%。表现状态差的患者NRM显著升高(P=.01)。2年和3年的RR估计分别为16%和20%，慢性移植物抗宿主病(CGVHD)患者的RR更低。1年和3年的PFS和OS率分别为62%和53%，66.0%和%，化疗敏感组明显优于对照组。结论异体SCT是治疗AITL的有效方法。移植后RR降低，以及异基因SCT后发生cGVHD的患者RR降低，都表明存在临床相关的移植物抗淋巴瘤效应。
PurposeTo analyze the long-term outcome in terms of nonrelapse mortality (NRM), relapse rate (RR), progression-free survival (PFS), and overall survival (OS) in patients with angioimmunoblastic T-cell lymphoma (AITL) treated with allogeneic stem-cell transplantation (alloSCT).Patients and MethodsForty-five patients with AITL who had undergone an alloSCT between January 1998 and December 2005 and were registered in the European Group for Blood and Marrow Transplantation database were analyzed. Median age was 48 years (range, 23 to 68 years), 34 patients had received >= two lines of chemotherapy before alloSCT, and 11 patients had experienced treatment failure with a prior autologous stem-cell transplantation. Twenty-five patients underwent a myeloablative alloSCT, and 20 underwent a reduced-intensity alloSCT. Donors were HLA-identical siblings in 26 patients. Twenty-seven patients were allografted in chemotherapy-sensitive disease, and 18 were allografted in refractory disease.ResultsThe cumulative incidence of NRM was 18%, 22%, and 25% at 3, 6, and 12 months, respectively. Patients with poor performance status had a significantly higher NRM (P = .01). RR was estimated as 16% and 20% at 2 and 3 years, respectively, and was lower in patients developing chronic graft-versus-host disease (cGVHD). PFS and OS rates were 62% and 53% and 66% and 64% at 1 and 3 years, respectively, and were significantly better in chemotherapy-sensitive patients.ConclusionAlloSCT represents a valid therapeutic option for patients with AITL. Both the lower RR after transplantation as well as the decreased RR in patients developing cGVHD after the alloSCT suggests the existence of a clinically relevant graft-versus-lymphoma effect.