Division of Hematology, University of Nantes, Hôtel-Dieu, Nantes; Centre de recherches en Cancérologie Nantes/Angers, INSERM, UMR 892, équipe 10, UFR Médecine et Techniques Médicales, Université de Nantes, Nantes; Centre d'Investigation Clinique en Cancérologie (CI2C); Unité de Recherche clinique en onco-hématologie, University of Nantes, Nantes, France.
Bone Marrow Transplantation Unit, University of Hamburg, Hamburg, Germany.
Ann Oncol. 2012 Oct;23(10):2695-2703. doi: 10.1093/annonc/mds054. Epub 2012 Mar 22.
Despite therapeutic approach that combines rituximab-containing chemotherapy, followed or not by autologous stem cell transplantation (auto-SCT), mantle cell lymphoma (MCL) patients experience relapses. Reduced-intensity conditioning allogeneic stem cell transplantation (RIC-allo-SCT) at time of relapse may represent an attractive strategy.
We report a multicenter retrospective analysis. Seventy MCL patients underwent RIC-allo-SCT in 12 centers.
Median age at transplantation was 56 years and median time from diagnosis to transplantation was 44 months. The median number of previous therapies was 2 (range, 1-5) including autologous transplantation in 47 cases. At time of transplantation, 35 patients were in complete remission, 20 were in partial response and 15 in stable disease or progressive disease. The median follow-up for living patients was 24 months. The 2-year event-free survival (EFS) and overall survival (OS) rates were 50% and 53%, respectively. The 1- and 2-year transplant-related mortality rates were 22% and 32%, respectively. The statistical analysis demonstrated that disease status at transplantation was the only parameter influencing EFS and OS.
These results suggest that RIC-allo-SCT may be an effective therapy in MCL patients with a chemo-sensitive disease at time of transplantation, irrespective of the number of lines of prior therapy. Studies are warranted to investigate the best type of RIC regimen.
尽管采用包含利妥昔单抗的化疗联合自体外周血干细胞移植(auto-SCT)的治疗方法,套细胞淋巴瘤(MCL)患者仍会复发。复发时采用减低强度预处理异基因造血干细胞移植(RIC-allo-SCT)可能是一种有吸引力的策略。
我们报告了一项多中心回顾性分析。70 例 MCL 患者在 12 个中心接受了 RIC-allo-SCT。
移植时的中位年龄为 56 岁,从诊断到移植的中位时间为 44 个月。既往治疗中位数为 2 次(范围 1-5 次),其中 47 例患者接受了自体移植。移植时,35 例患者处于完全缓解,20 例患者处于部分缓解,15 例患者处于稳定或进展疾病。存活患者的中位随访时间为 24 个月。2 年无事件生存率(EFS)和总生存率(OS)分别为 50%和 53%。1 年和 2 年的移植相关死亡率分别为 22%和 32%。统计分析表明,移植时的疾病状态是影响 EFS 和 OS 的唯一参数。
这些结果表明,RIC-allo-SCT 可能是一种有效的治疗方法,适用于移植时疾病对化疗敏感的 MCL 患者,而与既往治疗的线数无关。需要进一步研究以探讨最佳的 RIC 方案类型。