Department of Haematology, CHU de Nantes, Nantes, France.
Transplantation. 2012 Aug 15;94(3):295-301. doi: 10.1097/TP.0b013e318256dcba.
Impact of total-body irradiation (TBI) in conditioning regimen on outcome for patients with mantle cell lymphoma (MCL) remains unknown.
Patients with MCL who underwent autologous stem-cell transplantation (ASCT) in our institution were eligible for the present study (n=73). We analyzed the impact of various biologic and clinical parameters, with and without TBI, on patient outcome.
All patients presented with chemosensitive disease at transplantation. Median follow-up from ASCT was 37.2 months. One- and three-year overall survival (OS) rates were 90.3% and 74.5%, progression-free survival (PFS) rates were 85% and 59%, respectively. Three-year OS and PFS rates in the non-TBI group versus TBI group were similar: 80% versus 72.5% and 60% versus 57%, respectively. In univariate analysis, the use of TBI did not modify OS or PFS (P=0.93 and P=0.48, respectively). This remains true for patients who underwent ASCT up front. According to multivariate analysis, OS tended to be shorter for patients presenting with high Mantle Cell Lymphoma International Prognostic Index or low hemoglobin level.
Absence of TBI in conditioning regimen modifies neither PFS nor OS. The present retrospective and monocentric analysis shows that transplant patients with MCL remain highly exposed to relapse.
全身照射（TBI）在预处理方案中对套细胞淋巴瘤（MCL）患者的结果的影响尚不清楚。
在我们的机构中接受自体干细胞移植（ASCT）的 MCL 患者符合本研究的条件（n=73）。我们分析了有无 TBI 的各种生物学和临床参数对患者结果的影响。
所有患者在移植时均表现为化疗敏感疾病。从 ASCT 开始的中位随访时间为 37.2 个月。1 年和 3 年总生存率（OS）分别为 90.3%和 74.5%，无进展生存率（PFS）分别为 85%和 59%。非 TBI 组与 TBI 组的 3 年 OS 和 PFS 率相似：80%比 72.5%和 60%比 57%。在单因素分析中，TBI 的使用并未改变 OS 或 PFS（P=0.93 和 P=0.48）。这对于 upfront 接受 ASCT 的患者仍然适用。根据多因素分析，高套细胞淋巴瘤国际预后指数或低血红蛋白水平的患者 OS 往往较短。
预处理方案中无 TBI 既不影响 PFS 也不影响 OS。本回顾性和单中心分析表明，MCL 移植患者仍然高度易复发。
