Murashige Naoko, Kami Masahiro, Kishi Yukiko, Kim Sung-Won, Takeuchi Masami, Matsue Kosei, Kanda Yoshinobu, Hirokawa Makoto, Kawabata Yoshinari, Matsumura Tomoko, Kusumi Eiji, Hirabayashi Noriyuki, Nagafuji Koji, Suzuki Ritsuro, Takeuchi Kengo, Oshimi Kazuo
Haematopoietic Stem Cell Transplantation Unit, the National Cancer Centre Hospital and Department of Cell Therapy and Transplantation Medicine, University of Tokyo, Japan.
Br J Haematol. 2005 Aug;130(4):561-7. doi: 10.1111/j.1365-2141.2005.05651.x.
The efficacy of allogeneic haematopoietic stem-cell transplantation (allo-HSCT) for natural killer (NK)-cell neoplasms is unknown. We investigated the results of allo-HSCT for NK-cell neoplasms between 1990 and 2003 through questionnaires. After reclassification by a haematopathologist, of 345 patients who underwent allo-HSCT for malignant lymphoma, 28 had NK-cell neoplasms (World Health Organization classification): extranodal NK/T-cell lymphoma (n=22), blastic NK-cell lymphoma (n=3), and aggressive NK-cell leukaemia (n=3). Twelve were chemosensitive and 16 chemorefractory. Twenty-two had matched-related donors. Stem-cell source was bone marrow in eight and mobilised peripheral blood in 20. Conditioning regimens were myeloablative (n=23) and non-myeloablative (n=5). Grade 2-4 acute graft-versus-host disease (GVHD) and chronic GVHD developed in 12 and 8 respectively. Eight died of disease progression, three of infection, two of acute GVHD, one of veno-occlusive disease, one of interstitial pneumonitis, and one of thrombotic microangiopathy. Two-year progression-free and overall survivals were 34% and 40% respectively (median follow-up, 34 months). All patients who did not relapse/progress within 10 months achieved progression-free survival (PFS) during the follow-up. In multivariate analysis, stem cell source (BM versus peripheral blood; relative risk 3.03), age (>or=40 years vs. <40 years; relative risk 2.85), and diagnoses (extranodal NK/T-cell lymphoma versus others; relative risk 3.94) significantly affected PFS. Allo-HSCT is a promising treatment for NK-cell neoplasms.
异基因造血干细胞移植（allo-HSCT）治疗自然杀伤（NK）细胞肿瘤的疗效尚不清楚。我们通过问卷调查研究了1990年至2003年间allo-HSCT治疗NK细胞肿瘤的结果。经血液病理学家重新分类后，在345例接受allo-HSCT治疗恶性淋巴瘤的患者中，28例患有NK细胞肿瘤（世界卫生组织分类）：结外NK/T细胞淋巴瘤（n = 22）、母细胞性NK细胞淋巴瘤（n = 3）和侵袭性NK细胞白血病（n = 3）。12例对化疗敏感，16例化疗耐药。22例有匹配的相关供者。干细胞来源为骨髓的有8例，动员外周血的有20例。预处理方案为清髓性的有23例，非清髓性的有5例。分别有12例和8例发生了2-4级急性移植物抗宿主病（GVHD）和慢性GVHD。8例死于疾病进展，3例死于感染，2例死于急性GVHD，1例死于静脉闭塞性疾病，1例死于间质性肺炎，1例死于血栓性微血管病。两年无进展生存率和总生存率分别为34%和40%（中位随访时间34个月）。所有在10个月内未复发/进展的患者在随访期间均实现了无进展生存（PFS）。多因素分析显示，干细胞来源（骨髓与外周血；相对危险度3.03）、年龄（≥40岁与＜40岁；相对危险度2.85）和诊断（结外NK/T细胞淋巴瘤与其他；相对危险度3.94）显著影响PFS。allo-HSCT是治疗NK细胞肿瘤的一种有前景的治疗方法。
