Mociková H, Pytlík R, Raida L, Sýkorová A, Marková J, Král Z, Jindra P, Steinerová K, Válková V, Trnková M, Vacková B, Trnený M, Indrák K, Belada D, Mayer J, Koza V, Kozák T
Oddelení klinické hematologie, FN Královské Vinohrady Praha.
Klin Onkol. 2011;24(2):121-5.
This retrospective study evaluated treatment outcomes in patients undergoing autologous stem cell transplantation (ASCT) for relapsed/refractory Hodgkin lymphoma (HL).
Overall, 194 HL patients treated with ASCT between 2000 and 2009 were analyzed. Survival was calculated using Kaplan-Meier method and differences in survival between subgroups with log-rank test.
Best responses observed after ASCT: 124 complete and 35 partial remissions, 2 patients with stable disease and 33 relapses/progressions. During a median follow-up of 44 months, seventy patients after ASCT progressed/relapsed. Thirty-seven patients received salvage chemotherapy only with or without radiotherapy, 25 underwent allogeneic stem cell transplantation (SCT), 4 the second ASCT and 4 refused treatment. 5-year overall survival after ASCT was 71% and progression-free survival 54%. Median survival of the 70 patients relapsing after ASCT was 16.9 months. Median survival in patients after allogeneic SCT was 31.8 months and 12.4 months in patients treated with other modalities (p = 0.21). Overall mortality was 26.3% (51/194 patients): 13.4% progressions/relapses of HL and 12.9% non-relapse mortality.
Efficacy of ASCT was confirmed in 54% progression-free survivors. Median survival after ASCT failure is relatively short. There is a slightly longer overall survival after allogeneic SCT, although not statistically significant when compared to other approaches.
这项回顾性研究评估了接受自体干细胞移植(ASCT)治疗复发/难治性霍奇金淋巴瘤(HL)患者的治疗结果。
总共分析了2000年至2009年间接受ASCT治疗的194例HL患者。采用Kaplan-Meier法计算生存率,并通过对数秩检验比较亚组间的生存差异。
ASCT后观察到的最佳反应:124例完全缓解和35例部分缓解,2例疾病稳定,33例复发/进展。在中位随访44个月期间,70例ASCT后患者病情进展/复发。37例患者仅接受了挽救性化疗,有或没有放疗,25例接受了异基因干细胞移植(SCT),4例接受了第二次ASCT,4例拒绝治疗。ASCT后的5年总生存率为71%,无进展生存率为54%。ASCT后复发的70例患者的中位生存期为16.9个月。异基因SCT后患者的中位生存期为31.8个月,接受其他治疗方式的患者为12.4个月(p = 0.21)。总死亡率为26.3%(51/194例患者):HL进展/复发率为13.4%,非复发死亡率为12.9%。
54%的无进展生存者证实了ASCT的疗效。ASCT失败后的中位生存期相对较短。异基因SCT后的总生存期略长,尽管与其他方法相比无统计学意义。