Département d'Hématologie, Programme de Transplantation et de Thérapie Cellulaire, Institut Paoli-Calmettes, Marseille, France.
Bone Marrow Transplant. 2013 Feb;48(2):249-52. doi: 10.1038/bmt.2012.116. Epub 2012 Jun 25.
Allo-SCT is used to exploit GVL effect in high-risk relapsed non-Hodgkin's lymphoma (NHL). Here, we retrospectively analyzed 34 high-risk NHL patients who underwent auto-SCT followed closely by reduced-intensity allo-SCT ('tandem auto-allo') from January 2002 to November 2010. The search for an allogeneic donor was started at the beginning of salvage regimen. Median patients' age was 47 (27-68) years; histotypes were: diffuse large B-cell n=5, follicular n=14, transformed follicular n=4, mantle-cell n=5, plasmocytoid lymphoma n=1, anaplastic large T-cell n=2, peripheral T-cell n=3. Donors were HLA-identical siblings (n=29) or 10/10-matched unrelated individuals (n=5). Median interval between auto-SCT and allo-SCT was 77 days (36-197). At a median follow-up of 46 (8-108) months since allo-SCT, 5-year OS is 77% (61-93) and PFS is 68% (51-85). Disease relapse or progression occurred in six patients, 100-day TRM was 0%, 2-year TRM incidence was 6%. In conclusion, tandem transplantation is feasible in high-risk NHL patients having a HLA-identical donor. This approach could represent a suitable therapeutic option for those patients with high-risk NHL potentially benefitting from further therapy after auto-SCT. Donor searches should be started promptly whenever such an approach is chosen.
allo-SCT 用于利用高危复发非霍奇金淋巴瘤（NHL）中的 GVL 效应。在这里，我们回顾性分析了 2002 年 1 月至 2010 年 11 月期间接受自体-SCT 后紧接着进行低强度 allo-SCT（“串联自体- allo”）的 34 例高危 NHL 患者。在挽救方案开始时就开始寻找同种异体供体。中位患者年龄为 47 岁（27-68 岁）；组织学类型为：弥漫性大 B 细胞淋巴瘤 n=5、滤泡性 n=14、转化滤泡性 n=4、套细胞淋巴瘤 n=5、浆细胞样淋巴瘤 n=1、间变大细胞 T 细胞淋巴瘤 n=2、外周 T 细胞淋巴瘤 n=3。供体为 HLA 完全匹配的同胞（n=29）或 10/10 匹配的无关个体（n=5）。自体-SCT 和 allo-SCT 之间的中位间隔为 77 天（36-197）。在 allo-SCT 后中位随访 46 个月（8-108），5 年 OS 为 77%（61-93），PFS 为 68%（51-85）。6 例患者发生疾病复发或进展，100 天 TRM 为 0%，2 年 TRM 发生率为 6%。总之，在有 HLA 完全匹配供体的高危 NHL 患者中，串联移植是可行的。对于那些在自体-SCT 后可能受益于进一步治疗的高危 NHL 患者，这种方法可能是一种合适的治疗选择。只要选择这种方法，就应及时开始寻找供体。
