Balsalobre Pascual, Díez-Martín José L, Re Alessandro, Michieli Mariagrazia, Ribera José M, Canals Carmen, Rosselet Anne, Conde Eulogio, Varela Rosario, Cwynarski Kate, Gabriel Ian, Genet Philippe, Guillerm Gaelle, Allione Bernardino, Ferrant Augustin, Biron Pierre, Espigado Ildefonso, Serrano David, Sureda Anna
Hospital General Universitario [corrected] Gregorio Marañón, Madrid, Spain.
J Clin Oncol. 2009 May 1;27(13):2192-8. doi: 10.1200/JCO.2008.18.2683. Epub 2009 Mar 30.
Peripheral-blood autologous stem-cell transplantation (ASCT) in patients with HIV-related lymphoma (HIV-Ly) has been reported as a safe and useful procedure. Herein we report the European Group for Blood and Marrow Transplantation experience on patients with HIV-Ly undergoing ASCT.
This was a retrospective, multicentric, registry-based analysis.
Since 1999, 68 patients from 20 institutions (median age, 41 years; range, 29 to 62 years) were included, diagnosed with non-Hodgkin's lymphoma (NHL; n = 50) or Hodgkin's lymphoma (n = 18). At the time of ASCT, 16 patients were in first complete remission (CR1); 44 patients were in CR more than 1, partial remission, or chemotherapy-sensitive relapse (chemo-S); and eight patients had chemotherapy-resistant disease. The median number of CD34(+) cells infused was 4.5 x 10(6)/kg (range, 1.6 to 21.2 x 10(6)/kg). Median time to neutrophil and platelet engraftment were 11 days (range, 8 to 36 days) and 14 days (range, 6 to 455 days), respectively, with a cumulative incidence (CI) at 1 year of 95.6% and 87%, respectively. CI of nonrelapse mortality (NRM) was 7.5% at 12 months after ASCT, mainly because of bacterial infections. CI of relapse was 30.4% at 24 months, statistically related with not being in CR at ASCT (relative risk [RR] = 3.6), NHL histology other than diffuse large B-cell lymphoma (RR = 3.4), and use of more than two previous treatment lines (RR = 3). At a median follow-up of 32 months (range, 2 to 81 months), progression-free survival (PFS) was 56%. Patients not in CR or with refractory disease at ASCT had poorer PFS (RR = 2.4 and 4.8, respectively).
Similarly to HIV-negative patients with lymphoma, ASCT is a useful treatment for patients with HIV-Ly and is associated with low NRM, mainly when performed in early stages and chemo-S disease.
已有报道称，对感染人类免疫缺陷病毒相关淋巴瘤（HIV-Ly）的患者进行外周血自体干细胞移植（ASCT）是一种安全有效的治疗方法。在此，我们报告欧洲血液和骨髓移植组对接受ASCT的HIV-Ly患者的治疗经验。
这是一项基于登记的回顾性多中心分析。
自1999年以来，纳入了来自20家机构的68例患者（中位年龄41岁；范围29至62岁），诊断为非霍奇金淋巴瘤（NHL；n = 50）或霍奇金淋巴瘤（n = 18）。在进行ASCT时，16例患者处于首次完全缓解（CR1）状态；44例患者处于CR超过1次、部分缓解或化疗敏感复发（chemo-S）状态；8例患者患有化疗耐药性疾病。输注的CD34(+)细胞中位数为4.5×10(6)/kg（范围1.6至21.2×10(6)/kg）。中性粒细胞和血小板植入的中位时间分别为11天（范围8至36天）和14天（范围6至455天），1年时的累积发生率（CI）分别为95.6%和87%。ASCT后12个月时非复发死亡率（NRM）的CI为7.5%，主要原因是细菌感染。24个月时复发的CI为30.4%，与ASCT时未处于CR状态（相对风险[RR]=3.6）、非弥漫性大B细胞淋巴瘤的NHL组织学类型（RR = 3.4）以及之前使用超过两条治疗线（RR = 3）具有统计学相关性。中位随访32个月（范围2至81个月）时，无进展生存期（PFS）为56%。在ASCT时未处于CR状态或患有难治性疾病的患者PFS较差（RR分别为2.4和4.8）。
与HIV阴性淋巴瘤患者类似，ASCT对HIV-Ly患者是一种有效的治疗方法，且NRM较低，主要是在疾病早期和化疗敏感疾病时进行该治疗。
