Department of Hematology and Bone Marrow Transplantation, Rambam Medical Centre and Technion, Haifa, Israel.
Br J Haematol. 2009 Dec;147(5):719-28. doi: 10.1111/j.1365-2141.2009.07905.x. Epub 2009 Sep 30.
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.
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。