Rodríguez José, Conde Eulogio, Gutiérrez Antonio, Lahuerta Juan José, Arranz Reyes, Sureda Anna, Zuazu Javier, Fernández de Sevilla Alberto, Bendandi Maurizio, Solano Carlos, León Angel, Varela María Rosario, Caballero María Dolores
Oncology Department, University Hospital Son Dureta, Palma de Mallorca, Balearic Islands, Spain.
Haematologica. 2007 Aug;92(8):1067-74. doi: 10.3324/haematol.11173. Epub 2007 Jul 20.
Preliminary data on the use of autologous stem cell transplantation (ASCT) as a salvage therapy for peripheral T-cell lymphoma (PTCL) indicate that the results are similar to those obtained in aggressive B-cell lymphomas. The aim of our study was to analyze outcomes of a large series of patients with PTCL with a prolonged follow-up who received ASCT as salvage therapy.
Between 1990 and 2004, 123 patients in this situation were registered in the GELTAMO database. The median age at transplantation was 43.5 years; in 91% of patients the disease was chemosensitive.
Seventy-three percent of the patients achieved complete remission, 11% partial remission and the procedure failed in 16%. At a median follow-up of 61 months, the 5-year overall and progression-free survival rates were 45% and 34%, respectively. The presence of more than one factor of the adjusted International Prognostic Index (a-IPI) and a high beta2-microglobulin at transplantation were identified as adverse prognostic factors for both overall and progression-free survival and allowed the population to be stratified into three distinct risk groups.
Our data show that approximately one third of patients with PTCL in the salvage setting may enjoy prolonged survival following ASCT, provided they are transplanted in a chemosensitive disease state. The a-IPI and beta2-microglobulin level predict the outcome after ASCT in relapsing/refractory PTCL.
关于使用自体干细胞移植(ASCT)作为外周T细胞淋巴瘤(PTCL)挽救治疗的初步数据表明,其结果与侵袭性B细胞淋巴瘤相似。我们研究的目的是分析一大系列接受ASCT作为挽救治疗且随访时间延长的PTCL患者的预后情况。
1990年至2004年间,123例处于这种情况的患者被纳入GELTAMO数据库。移植时的中位年龄为43.5岁;91%的患者疾病对化疗敏感。
73%的患者实现完全缓解,11%部分缓解,16%的患者治疗失败。中位随访61个月时,5年总生存率和无进展生存率分别为45%和34%。调整后的国际预后指数(a-IPI)存在一个以上因素以及移植时β2微球蛋白水平高被确定为总生存和无进展生存的不良预后因素,并可将患者人群分为三个不同的风险组。
我们的数据表明,处于挽救治疗阶段的PTCL患者中,约三分之一在ASCT后可能获得长期生存,前提是他们在化疗敏感的疾病状态下接受移植。a-IPI和β2微球蛋白水平可预测复发/难治性PTCL患者ASCT后的预后。