Long-term results of autologous hematopoietic cell transplantation for peripheral T cell lymphoma: the Stanford experience.
Long-term results of autologous hematopoietic cell transplantation for peripheral T cell lymphoma: the Stanford experience.
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DOI：
10.1016/j.bbmt.2008.04.004
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发表时间：
2008-07
影响因子：
4.3
通讯作者：
Laport, Ginna G.
中科院分区：
文献类型：
--
作者：
Chen, Andy I.;McMillan, Alex;Neprin, Robert S.;Horning, Sandra J.;Laport, Ginna G.
与B细胞非霍奇金淋巴瘤相比，外周T细胞淋巴瘤（PTCL）预后较差。PTCL尚无统一的标准治疗方法，由于常规治疗效果不佳，常在首次缓解或复发时进行自体造血细胞移植（AHCT）巩固治疗。我们对1989年至2006年接受AHCT治疗PTCL的患者进行了回顾性分析。共发现53例病例，包括系统性间变性大细胞（n = 18）、未指明的PTCL（n = 17）、血管免疫母细胞（n = 9）、鼻型淋巴结NK/T（n = 7）、肝脾（n = 2）和成人T细胞白血病/淋巴瘤（n = 1）。15例患者在第一次完全或部分反应（CR 1/PR 1），32例在第二次或超过CR或PR（CR2/PR 2+），11例原发性难治性疾病（REF）。中位随访时间为5年（范围：1.0-11.5），5年无进展生存期（PFS）和总生存期（OS）分别为25%和48%。AHCT时的疾病状态对PFS和OS有显著影响。CR 1/PR 1、CR2/PR 2+和REF患者的5年PFS分别为51%、12%和0%，OS的相应数字分别为76%、40%和30%。影响生存率的移植前因素是疾病状态和既往治疗方案的数量。组织学、年龄、性别、分期、B症状、骨髓受累和首次缓解持续时间对PFS或OS无显著影响。基于这些结果，AHCT作为首次完全或部分缓解的巩固治疗可能提供持久的生存获益。然而，AHCT联合常规挽救化疗在复发性或难治性PTCL患者中的持久获益最小，因此应更积极地探索新策略和/或同种异体HCT替代AHCT治疗复发性/难治性PTCL。
The peripheral T cell lymphomas (PTCL) carry a worse prognosis compared to B cell non-Hodgkin lymphoma. There is no uniform standard therapy for PTCL, and autologous hematopoietic cell transplant (AHCT) is often offered as consolidation in first remission or at relapse because of the poor outcomes with conventional therapy. We conducted a retrospective review of patients who underwent AHCT for PTCL from 1989 to 2006. Fifty-three cases were identified consisting of systemic anaplastic large cell (n = 18), PTCL unspecified (n = 17), angioimmunoblastic (n = 9), nasal type extranodal NK/T (n = 7), hepatosplenic (n = 2), and adult T cell leukemia/lymphoma (n = 1). Fifteen patients were transplanted in first complete or partial response (CR1/PR1), 32 in second or beyond CR or PR (CR2/PR2+), and 11 with primary refractory disease (REF). With a median follow-up was 5 years (range: 1.0–11.5), the 5-year progression-free survival (PFS) and overall survival (OS) were 25% and 48%, respectively. Disease status at AHCT had a significant impact on PFS and OS. The 5-year PFS for patients in CR1/PR1, CR2/PR2+, and REF was 51%, 12%, and 0%, respectively, and the corresponding figures for OS were 76%, 40%, and 30%, respectively. The pretransplant factors that impacted survival were disease status and the number of prior regimens. Histology, age, sex, stage, B symptoms, bone marrow involvement, and duration of first response did not significantly affect PFS or OS. Based on these results, AHCT as consolidation therapy in first complete or partial response may offer a durable survival benefit. However, AHCT with conventional salvage chemotherapy has minimal durable benefit in patients with relapsed or refractory PTCL, and thus novel strategies and/or allogeneic HCT should be more aggressively explored in lieu of AHCT for relapsed/ refractory PTCL.
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影响因子：
45.3
作者：
Went, Philip;Agostinelli, Claudio;Pileri, Stefano A.
通讯作者：
Pileri, Stefano A.
影响因子：
10.1
作者：
Rodriguez, Jose;Conde, Eulogio;Dolores Caballero, Maria
通讯作者：
Dolores Caballero, Maria
影响因子：
4.8
作者：
Blystad, AK;Enblad, G;Hagberg, H
通讯作者：
Hagberg, H
影响因子：
20.3
作者：
NEGRIN, RS;KUSNIERZGLAZ, CR;STROBER, S
通讯作者：
STROBER, S
影响因子：
45.3
作者：
Corradini, P;Dodero, A;Tarella, C
通讯作者：
Tarella, C