大剂量化疗后自体干细胞移植治疗复发或难治性霍奇金淋巴瘤：预后特征及结果
High-dose chemotherapy followed by autologous stem cell transplantation for relapsed or refractory Hodgkin lymphoma: prognostic features and outcomes.
作者信息
Engelhardt Brian G, Holland Derek W, Brandt Stephen J, Chinratanalab Wichai, Goodman Stacey A, Greer John P, Jagasia Madan H, Kassim Adetola A, Morgan David S, Ruffner Katherine L, Schuening Friedrich G, Wolff Steven, Bitting Rhonda, Sulur Paulgun, Stein Richard S
机构信息
Division of Hematology and Oncology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.
出版信息
Leuk Lymphoma. 2007 Sep;48(9):1728-35. doi: 10.1080/10428190701534374.
Between January 1990 and April 2001, 115 patients received high-dose chemotherapy (HDT) followed by autologous stem cell transplantation (ASCT) for relapsed or refractory Hodgkin lymphoma (HL). With a median follow-up of 58 months (range, 1 - 175 months), 5-year progression-free survival (PFS) and overall survival (OS) were 46% and 58%, respectively. Twelve patients with primary refractory disease had a 5-year PFS of 41% and OS of 58%, not significantly different from those of the remaining cohort. Early and overall regimen related mortality were 7% and 16%, respectively. Male gender (P = 0.04) and a time to relapse (TTR) < 12 months (P = 0.03) were associated with decreased OS by univariate analysis. In multivariate analysis, TTR < 12 months remained statistically significant (P = 0.04). We have confirmed that HDT and ASCT result in long-term survival for a proportion of patients with relapsed or refractory HL. All patients, including those with primary refractory disease, benefited from HDT and ASCT.
1990年1月至2001年4月期间，115例复发或难治性霍奇金淋巴瘤（HL）患者接受了大剂量化疗（HDT），随后进行自体干细胞移植（ASCT）。中位随访时间为58个月（范围1 - 175个月），5年无进展生存期（PFS）和总生存期（OS）分别为46%和58%。12例原发性难治性疾病患者的5年PFS为41%，OS为58%，与其余队列患者无显著差异。早期和总体方案相关死亡率分别为7%和16%。单因素分析显示，男性（P = 0.04）和复发时间（TTR）< 12个月（P = 0.03）与OS降低相关。多因素分析中，TTR < 12个月仍具有统计学意义（P = 0.04）。我们已证实，HDT和ASCT可使一部分复发或难治性HL患者获得长期生存。所有患者，包括原发性难治性疾病患者，均从HDT和ASCT中获益。
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