Reimer Peter
Klinik für Hämatologie, Internistische Onkologie und Stammzelltransplantation, Kliniken Essen Süd, Evangelisches Krankenhaus Essen-Werden gGmbH, Pattbergstra β e 1-3, 45239 Essen, Germany.
Adv Hematol. 2010;2010:320624. doi: 10.1155/2010/320624. Epub 2010 Dec 21.
Peripheral T/NK-cell lymphomas (PTCLs) are rare malignancies characterized by poor prognosis. So far, no standard therapy has been established, due to the lack of randomised studies. High-dose therapy and autologous stem cell transplantation (HDT-autoSCT) have shown good feasibility with low toxicity in retrospective studies. In relapsing and refractory PTCL several comparison analyses suggest similar efficacy for PTCL when compared with aggressive B-cell lymphoma. In the upfront setting, prospective data show promising results with a long-lasting overall survival in a relevant subset of patients. Achieving a complete remission at transplantation seems to be the most important prognostic factor. Allogeneic stem cell transplantation (alloSCT) has been investigated only as salvage treatment. Especially when using reduced intensity conditioning regimen, eligible patients seem to benefit from this approach. To define the role for upfront stem cell transplantation a randomised trial by the German High-Grade Non-Hodgkin Lymphoma Study Group comparing HDT-autoSCT and alloSCT will be initiated this year.
外周T/NK细胞淋巴瘤（PTCL）是一类预后较差的罕见恶性肿瘤。由于缺乏随机对照研究，目前尚未确立标准治疗方案。回顾性研究显示，大剂量化疗联合自体干细胞移植（HDT-autoSCT）具有良好的可行性且毒性较低。在复发难治性PTCL中，多项比较分析表明，与侵袭性B细胞淋巴瘤相比，PTCL的疗效相似。在一线治疗中，前瞻性数据显示，在一部分相关患者中，总生存期持久，结果令人鼓舞。移植时实现完全缓解似乎是最重要的预后因素。异基因干细胞移植（alloSCT）仅作为挽救治疗进行了研究。特别是采用减低剂量预处理方案时，符合条件的患者似乎能从这种治疗方法中获益。为明确一线干细胞移植的作用，德国高级别非霍奇金淋巴瘤研究组将于今年启动一项比较HDT-autoSCT和alloSCT的随机试验。
