Adult Bone Marrow Transplantation Service; Memorial Sloan-Kettering Cancer Center, New York, NY.
Department of Medicine; Memorial Sloan-Kettering Cancer Center, New York, NY.
Leuk Lymphoma. 2012 Jun;53(6):1124-1129. doi: 10.3109/10428194.2011.645818. Epub 2012 Jan 31.
Peripheral T-cell non-Hodgkin lymphomas (T-NHL) are rare diseases, with a worse prognosis compared to their B-cell counterparts. Allogeneic hematopoietic stem cell transplant may have a role in the treatment of relapsed/refractory disease or high-risk histologies in the upfront setting. However, there is limited information on the efficacy of allogeneic transplant for these diseases, as well as what factors may predict outcomes. We therefore performed a retrospective study of 34 patients who received an allogeneic transplant for the treatment of T-NHL at a single center between 1 January 1992 and 31 December 2009. The median follow-up for survivors was 45 months (range 9-160 months). The 2-year overall survival (OS) was 0.61 (95% confidence interval [CI]: 0.43-0.75) with a plateau at 28 months. Ki-67 expression ≤ 25% was predictive of improved OS (p < 0.01), and transplant in complete remission was predictive of a decreased cumulative incidence of events (p = 0.04). Three patients received a donor leukocyte infusion, and two patients demonstrated a response, supporting a graft-versus-lymphoma effect. These data demonstrate that allogeneic transplant is a viable option for the treatment of T-NHL and merits prospective evaluation.
外周 T 细胞非霍奇金淋巴瘤（T-NHL）是罕见疾病，与 B 细胞非霍奇金淋巴瘤相比，其预后更差。异基因造血干细胞移植可能在复发/难治性疾病或高风险组织学的一线治疗中发挥作用。然而，对于这些疾病，异基因移植的疗效以及哪些因素可能预测结局的信息有限。因此，我们对 1992 年 1 月 1 日至 2009 年 12 月 31 日在单一中心接受异基因移植治疗 T-NHL 的 34 例患者进行了回顾性研究。幸存者的中位随访时间为 45 个月（范围 9-160 个月）。2 年总生存率（OS）为 0.61（95%置信区间[CI]：0.43-0.75），28 个月时达到平台期。Ki-67 表达≤25%可预测 OS 改善（p<0.01），完全缓解时移植可预测事件累积发生率降低（p=0.04）。3 例患者接受了供者白细胞输注，其中 2 例患者有反应，支持移植物抗淋巴瘤效应。这些数据表明，异基因移植是治疗 T-NHL 的一种可行选择，值得前瞻性评估。
