Department of Hematology and Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
Am J Hematol. 2012 Aug;87(8):770-5. doi: 10.1002/ajh.23246. Epub 2012 May 28.
The outcome after allogeneic hematopoietic stem cell transplantation (allo-HCT) for diffuse large B-cell lymphoma (DLBCL) associated with follicular lymphoma (FL), which includes DLBCL with pre- or co-existing FL, remains controversial, and few previous reports have compared the outcomes after allo-HCT for FL, DLBCL associated with FL, and de novo DLBCL. We retrospectively analyzed 97 consecutive patients with FL (n = 46), DLBCL associated with FL (n = 22), or de novo DLBCL (n = 29) who received allo-HCT at our institute between 2000 and 2010. With a median follow-up of 53 months, the 5-year overall survival (OS) and progression-free survival (PFS) were, respectively, 77% and 70% for FL, 62% and 57% for DLBCL associated with FL, and 26% and 23% for de novo DLBCL. The 5-year cumulative incidences of non-relapse mortality and disease progression/relapse were, respectively, 16% and 15% for FL, 19% and 24% for DLBCL associated with FL, and 36% and 41% for de novo DLBCL. By a multivariate analysis, the OS and PFS for DLBCL associated with FL were significantly better than those for de novo DLBCL, whereas they were not significantly different from those for FL. These results suggest that allo-HCT may be a promising option for patients with not only advanced FL but also DLBCL associated with FL.
异基因造血干细胞移植（allo-HCT）治疗弥漫性大 B 细胞淋巴瘤（DLBCL）伴滤泡淋巴瘤（FL）的疗效仍存在争议，既往研究比较了allo-HCT 治疗 FL、DLBCL 伴发 FL 和初治 DLBCL 的结果较少。我们回顾性分析了 2000 年至 2010 年在我院接受 allo-HCT 的 97 例连续患者，其中 FL（n=46）、DLBCL 伴发 FL（n=22）和初治 DLBCL（n=29）。中位随访 53 个月，FL、DLBCL 伴发 FL 和初治 DLBCL 的 5 年总生存（OS）率和无进展生存（PFS）率分别为 77%和 70%、62%和 57%、26%和 23%。FL、DLBCL 伴发 FL 和初治 DLBCL 的 5 年非复发死亡率和疾病进展/复发累积发生率分别为 16%和 15%、19%和 24%、36%和 41%。多因素分析显示，DLBCL 伴发 FL 的 OS 和 PFS 明显优于初治 DLBCL，与 FL 无显著差异。这些结果提示，allo-HCT 可能是治疗晚期 FL 和 DLBCL 伴发 FL 患者的一种有前途的选择。
