University of Maryland Greenebaum Cancer Center, Baltimore, MD 21201-1595, United States.
Cancer Treat Rev. 2013 Feb;39(1):51-9. doi: 10.1016/j.ctrv.2012.03.011. Epub 2012 Apr 25.
Peripheral T-cell lymphoma (PTCL) is a heterogeneous group of non-Hodgkin's lymphoma that carries, except for ALK-positive anaplastic large cell lymphoma, a poor prognosis. Only a third of patients live 5years past diagnosis. The incidence of PTCL has been increasing during the last two decades. In recent years, there was a rising interest in PTCL manifested by the abundance of publications dedicated exclusively to this disease. The international T-cell lymphoma project was formed with an aim of unifying efforts towards a better understanding of the diagnosis and management of this disease. Given the poor outcomes of PTCL patients, high-dose chemotherapy and autologous stem-cell transplantation (HDT/ASCT) have been used in the up-front and salvage settings, with different success rates. However, there are no prospective randomized controlled trials addressing the role of HDT/ASCT in a PTCL-restricted population. This article critically reviews the data available from the retrospective and prospective studies addressing this topic. We will emphasize the favorable prognostic factors of HDT/ASCT such as a solid remission at the time of transplantation, a chemotherapy sensitive disease and a low prognostic index score. As novel agents and new therapeutic strategies are introduced, there is a continued need for prospective randomized trials to define the optimal use of HDT/ASCT in managing PTCL.
外周 T 细胞淋巴瘤（PTCL）是一组异质性非霍奇金淋巴瘤，除间变性大细胞淋巴瘤（ALK 阳性）外，预后均较差。仅有三分之一的患者在诊断后能存活 5 年以上。在过去的二十年中，PTCL 的发病率一直在增加。近年来，人们对外周 T 细胞淋巴瘤的兴趣日益浓厚，专门针对这种疾病的出版物层出不穷。国际 T 细胞淋巴瘤项目的成立旨在统一努力，以更好地了解这种疾病的诊断和治疗。鉴于 PTCL 患者的预后较差，高剂量化疗和自体造血干细胞移植（HDT/ASCT）已在前瞻性和挽救性治疗中使用，成功率不同。然而，目前尚无前瞻性随机对照试验探讨 HDT/ASCT 在局限于 PTCL 患者中的作用。本文批判性地回顾了关于这个主题的回顾性和前瞻性研究中的可用数据。我们将强调 HDT/ASCT 的有利预后因素，如移植时的完全缓解、化疗敏感疾病和低预后指数评分。随着新型药物和新的治疗策略的引入，需要进行前瞻性随机试验来确定 HDT/ASCT 在管理 PTCL 中的最佳应用。
