Jantunen E, Wiklund T, Juvonen E, Putkonen M, Lehtinen T, Kuittinen O, Franssila K, Söderström K-O, Leppä S, Elonen E, Remes K, Nousiainen T
Department of Medicine, Kuopio University Hospital, Kuopio, Finland.
Bone Marrow Transplant. 2004 Feb;33(4):405-10. doi: 10.1038/sj.bmt.1704367.
Limited experience is available on the feasibility and efficacy of high-dose therapy (HDT) supported by autologous stem cell transplantation (ASCT) in patients with peripheral T-cell lymphoma (PTCL). Therefore, a nation-wide survey was conducted in adult patients transplanted for PTCL in Finland during 1990-2001. After histopathology review, 37 patients were identified. The median age was 46 years (16-68) at the time of ASCT. Histology included PTCL not otherwise specified in 14 patients, anaplastic large cell lymphoma (ALCL) in 14 patients, and other in nine patients. Disease status at the time of ASCT was CR/PR1 in 18 patients; CR/PR2 in 14 patients, and other in five patients. HDT consisted of either BEAC (N=22) or BEAM (N=15), supported by blood stem cells in 34 patients (92%). Early transplant-related mortality was 11%. With a median follow-up of 24 months from HDT, 16 patients (43%) have relapsed or progressed. The estimated 5-year overall survival (OS) was 54%. Patients with ALCL had superior OS when compared with other subtypes (85 vs 35%, P=0.007). OS at 5 years was 63% in patients transplanted in CR/PR1 vs 45% in those transplanted in other disease status (P=NS). Prospective studies are needed to define the role of ASCT in this lymphoma type.
关于高剂量疗法（HDT）联合自体干细胞移植（ASCT）治疗外周T细胞淋巴瘤（PTCL）患者的可行性和疗效，目前经验有限。因此，对1990年至2001年期间在芬兰接受PTCL移植的成年患者进行了一项全国性调查。经组织病理学复查，确定了37例患者。ASCT时的中位年龄为46岁（16 - 68岁）。组织学类型包括14例未另行规定的PTCL、14例间变性大细胞淋巴瘤（ALCL）和9例其他类型。ASCT时的疾病状态为18例CR/PR1；14例CR/PR2，5例其他。HDT方案包括BEAC（N = 22）或BEAM（N = 15），34例患者（92%）接受了血干细胞支持。早期移植相关死亡率为11%。自HDT起中位随访24个月，16例患者（43%）复发或病情进展。估计5年总生存率（OS）为54%。与其他亚型相比，ALCL患者的OS更高（85%对35%，P = 0.007）。CR/PR1状态下移植患者的5年OS为63%，而其他疾病状态下移植患者的5年OS为45%（P = 无显著性差异）。需要进行前瞻性研究来明确ASCT在这种淋巴瘤类型中的作用。
