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131 例滤泡淋巴瘤患者接受匹配无关供者干细胞移植:来自欧洲血液和骨髓移植学会淋巴瘤工作组的分析。

Matched unrelated donor stem cell transplant in 131 patients with follicular lymphoma: an analysis from the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation.

机构信息

Department of Hematology and Bone Marrow Transplantation, Rambam Medical Centre and Technion, Haifa, Israel.

出版信息

Br J Haematol. 2009 Dec;147(5):719-28. doi: 10.1111/j.1365-2141.2009.07905.x. Epub 2009 Sep 30.

Abstract

Matched unrelated donor stem cell transplantation (MUD-SCT) provides the only curative option for patients with follicular lymphoma (FL) who fail conventional therapies and do not have a sibling donor. The purpose of this study was to analyse the outcome of patients with FL treated with MUD-SCT included in the European Group for Blood and Marrow Transplantation registry. 131 patients treated with reduced-intensity conditioning (RIC, n = 87) or conventional myeloablative (CONV, n = 44) MUD-SCT between 2000 and 2005 were included. Median time from diagnosis to MUD-SCT was 47 months and the median number of previous therapeutic regimens was 4 (previous autograft: 47%). RIC recipients were significantly older, with a longer interval from diagnosis to MUD-SCT and had failed a previous autograft more frequently than CONV recipients. Non-relapse mortality (NRM) was 24% and 30% at 100-d and 1-year, respectively. After a median follow-up of 36 months, 17% of the patients developed disease progression, the 3-year progression-free survival (PFS) being 47%. Three-year overall survival (OS) for the whole series was 51%. On multivariate analysis, RIC regimens were associated with at lower NRM and a significantly longer PFS and OS. This retrospective study demonstrated that MUD-SCT results, even in heavily pre-treated populations, in a meaningful PFS and OS.

摘要

无关供者造血干细胞移植(MUD-SCT)为常规治疗失败且无同胞供者的滤泡性淋巴瘤(FL)患者提供了唯一的治愈选择。本研究旨在分析欧洲血液和骨髓移植学会登记处纳入的接受 MUD-SCT 治疗的 FL 患者的结局。2000 年至 2005 年间,纳入了 131 例接受低强度预处理(RIC,n=87)或常规清髓性预处理(CONV,n=44)MUD-SCT 的患者。从诊断到 MUD-SCT 的中位时间为 47 个月,中位治疗方案数为 4 个(既往自体移植:47%)。RIC 组患者年龄明显更大,从诊断到 MUD-SCT 的时间间隔更长,且既往自体移植失败的频率高于 CONV 组。非复发死亡率(NRM)在 100 天和 1 年时分别为 24%和 30%。中位随访 36 个月后,17%的患者发生疾病进展,3 年无进展生存率(PFS)为 47%。全组 3 年总生存率(OS)为 51%。多因素分析显示,RIC 方案与较低的 NRM 以及更长的 PFS 和 OS 相关。这项回顾性研究表明,即使在预处理较重的人群中,MUD-SCT 也能带来有意义的 PFS 和 OS。

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