Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA.
Biol Blood Marrow Transplant. 2010 Apr;16(4):443-68. doi: 10.1016/j.bbmt.2010.01.008. Epub 2010 Jan 28.
Clinical research examining the role of hematopoietic stem cell transplantation (SCT) in the therapy of follicular non-Hodgkin lymphoma in adults is presented and critically evaluated in this systematic evidence-based review. Specific criteria were used for searching the published literature and for grading the quality and strength of the evidence and the strength of the treatment recommendations. Treatment recommendations reached unanimously by a panel of follicular lymphoma experts are: (1) autologous SCT is recommended as salvage therapy based on pre-rituximab data, with a significant improvement in overall survival (OS) and progression-free (PFS) survival; (2) autologous SCT is not recommended as first-line treatment for most patients because of no significant improvement in OS; (3) autologous SCT is recommended for transformed follicular lymphoma patients; (4) reduced intensity conditioning before allogeneic SCT appears to be an acceptable alternative to myeloablative regimens; (5) an HLA-matched unrelated donor appears to be as effective an HLA-matched related donor for reduced intensity conditioning allogeneic SCT. There are insufficient data to make a recommendation on the use of autologous SCT after rituximab-based salvage therapy. Eleven areas of needed research in the treatment of follicular lymphoma with SCT were identified and are presented in the review.
本系统循证综述介绍并批判性评估了评估造血干细胞移植（SCT）在成人滤泡性非霍奇金淋巴瘤治疗中作用的临床研究。本研究使用特定标准搜索已发表文献，并对证据质量和强度以及治疗建议的强度进行分级。滤泡性淋巴瘤专家小组一致提出的治疗建议如下：（1）基于利妥昔单抗治疗前的数据，自体 SCT 被推荐作为挽救疗法，可显著提高总生存率（OS）和无进展生存率（PFS）；（2）由于 OS 无显著改善，自体 SCT 不推荐作为大多数患者的一线治疗；（3）自体 SCT 推荐用于转化滤泡性淋巴瘤患者；（4）异基因 SCT 前的减强度预处理似乎是与清髓性方案相当的可接受替代方案；（5）对于减强度预处理的异基因 SCT，HLA 匹配的无关供体与 HLA 匹配的亲缘供体同样有效。基于利妥昔单抗治疗后的挽救疗法，尚缺乏推荐自体 SCT 使用的相关数据。本综述还确定了在 SCT 治疗滤泡性淋巴瘤中需要研究的 11 个领域，并进行了介绍。
