Rodriguez J, Munsell M, Yazji S, Hagemeister F B, Younes A, Andersson B, Giralt S, Gajewski J, de Lima M, Couriel D, Romaguera J, Cabanillas F F, Champlin R E, Khouri I F
Department of Blood and Marrow Transplantation, University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA.
J Clin Oncol. 2001 Sep 1;19(17):3766-70. doi: 10.1200/JCO.2001.19.17.3766.
To evaluate the outcome of high-dose chemotherapy (HDCT) and autologous or allogeneic hematopoietic transplantation in patients with peripheral T-cell lymphoma (PTCL) who experienced disease recurrence after prior conventional chemotherapy.
We performed a retrospective analysis of 36 PTCL patients from the University of Texas M.D. Anderson Cancer Center treated between 1989 and 1998 with HDCT and autologous or allogeneic hematopoietic transplantation.
A total of 36 patients were studied (29 received autologous transplantation, and seven received allogeneic transplantation). The overall survival rate at 3 years was 36% (95% confidence interval [CI], 23% to 59%), and the progression-free survival (PFS) rate was 28% (95% CI, 16% to 49%). The pretransplant serum lactate dehydrogenase level was the most important prognostic factor for both survival and PFS rates (P < .001). A Pretransplant International Prognostic Index score of < or = 1 indicated a superior survival rate (P = .036) but not an improved PFS rate. A median follow-up of 43 months (range, 13 to 126 months) showed 13 patients (36%) were still alive with no evidence of disease.
Our results are comparable to the published data on HDCT in B-cell non-Hodgkin's lymphoma (NHL) patients despite the fact that patients with PTCL are known to have a worse outcome compared with B-cell NHL patients. Considering the dismal outcome of conventional chemotherapy in PTCL patients, these data suggest the hypothesis that the poor prognostic implication of T-cell phenotyping in NHL might be overcome by frontline HDCT and transplantation.
评估接受过常规化疗后疾病复发的外周T细胞淋巴瘤（PTCL）患者接受大剂量化疗（HDCT）及自体或异基因造血移植的疗效。
我们对1989年至1998年间在德克萨斯大学MD安德森癌症中心接受HDCT及自体或异基因造血移植治疗的36例PTCL患者进行了回顾性分析。
共研究了36例患者（29例接受自体移植，7例接受异基因移植）。3年总生存率为36%（95%置信区间[CI]，23%至59%），无进展生存率（PFS）为28%（95%CI，16%至49%）。移植前血清乳酸脱氢酶水平是生存率和PFS率最重要的预后因素（P<.001）。移植前国际预后指数评分≤1表明生存率较高（P=.036），但PFS率未提高。中位随访43个月（范围13至126个月）显示，13例患者（36%）仍存活且无疾病证据。
尽管已知PTCL患者的预后比B细胞非霍奇金淋巴瘤（NHL）患者差，但我们的结果与已发表的关于B细胞NHL患者HDCT的数据相当。考虑到PTCL患者常规化疗的预后不佳，这些数据提示了一个假设，即NHL中T细胞表型的不良预后影响可能通过一线HDCT和移植得以克服。
