High-dose therapy with autologous stem cell transplantation in patients with peripheral T cell lymphomas
High-dose therapy with autologous stem cell transplantation in patients with peripheral T cell lymphomas
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DOI：
10.1038/sj.bmt.1702867
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发表时间：
2001-04-01
影响因子：
4.8
通讯作者：
Hagberg, H
中科院分区：
文献类型：
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作者：
Blystad, AK;Enblad, G;Hagberg, H
外周T细胞淋巴瘤(PTCL)经常规治疗后预后较高级别B细胞淋巴瘤差，大剂量联合自体干细胞支持治疗(HDT)在这些患者中的地位尚不清楚。自1990年2月至1999年9月，在挪威奥斯陆的挪威放射科医院和瑞典乌普萨拉的大学医院接受HDT和自体干细胞支持治疗的PTCL患者40例，其中女性10例，男性30例，年龄中位数41.5岁(16-61岁)。组织学亚型为：不明原因的PTCL 20例，肠道2例，血管免疫母细胞瘤(AILD)2例，血管中心性2例，间变性大细胞淋巴瘤(ALCL)14例。所有患者都有化疗敏感性疾病，并在移植前接受了含有蒽环类药物的治疗。HDT时，PR17例，PR23例，BEAC 15例，BEAC 14例，环磷酰胺+全身照射8例，BEAC+足叶乙甙+全身照射1例，米托蒽醌+马法兰2例。有3例(7.5%)与治疗相关的死亡。总生存率(OS)为58%，无事件生存率(EFS)为48%，无复发生存率(RFS)为56%，中位随访期为36个月(7~100个月)。ALCL患者的预后好于其他PTCL亚型患者，OS分别为79%和44%。总之，对化疗敏感的PTCL患者，如果一线化疗未能达到CR或复发，可以成功地采用HDT和自体干细胞支持治疗。
Peripheral T cell lymphomas (PTCL) have a poorer prognosis after conventional treatment than do high-grade B cell lymphomas, The place for high-dose therapy (HDT) with autologous stem cell support in these patients is still not clear. Forty patients, 10 women and 30 men, median age 41.5 years (range 16-61) with PTCL were treated with HDT and autologous stem cell support at The Norwegian Radium Hospital, Oslo, Norway and The University Hospital, Uppsala, Sweden, between February 1990 and September 1999, The histologic subtypes were: PTCL unspecified, 20 patients; intestinal, two patients; angioimmunoblastic (AILD), two patients; angiocentric, two patients and anaplastic large cell lymphoma (ALCL), 14 patients. All patients had chemosensitive disease and had received anthracycline-containing regimens prior to transplantation. At the time of HDT, 17 patients were in first PR or CR and 23 were in second or third PR or CR, Conditioning regimens were BEAM in 15 patients, BEAC in 14 patients, cyclophosphamide and total body irradiation (TBI) in eight patients, BEAC, without etoposide and TBI in one patient and mitoxantrone and melphalan in two patients. There were three (7.5%) treatment-related deaths. The estimated overall survival (OS) at 3 years was 58%, the event-free survival (EFS) 48% and the relapse-free survival (RFS) 56%, with a median followup of 36 months (range 7-100) for surviving patients. The patients with ALCL tended to have a better prognosis compared to those with other PTCL subtypes, OS 79% vs 44%, respectively. In conclusion, patients with chemosensitive PTCL who are failing to achieve CR with first-line chemotherapy or are in relapse can successfully be treated with HDT and autologous stem cell support.