Department of Medical Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China.
Int J Hematol. 2014 Jan;99(1):69-78. doi: 10.1007/s12185-013-1465-y. Epub 2013 Nov 21.
Peripheral T-cell lymphoma (PTCL) carries a poor prognosis with conventional treatment. We retrospectively analyzed data from 45 patients with PTCL who received high-dose therapy and autologous stem cell transplantation (HDT/ASCT) from 1990 to 2008 in our center. Eighteen patients underwent HDT/ASCT in complete remission to induction chemotherapy (CR1), and 27 patients underwent HDT/ASCT in other disease statuses. The median follow-up was 113.5 months (range 52.6-261.0) for surviving patients. The 5-year overall survival (OS) and progression-free survival (PFS) were 64 and 60 %, respectively. The 5-year OS for patients in CR1 and in other disease statuses was 89 and 47 %, respectively (P = 0.002), and 5-year PFS was 83 and 43 % (P = 0.007). In the subgroup excluding anaplastic large cell lymphoma, patients transplanted in CR1 also had significantly better 5-year OS (82 vs. 37 %, P = 0.009) and PFS (82 vs. 33 %, P = 0.008) than those transplanted in other disease statuses. Multivariate analysis showed that CR1 status was the only significant prognostic factor for OS (P = 0.040) and PFS (P = 0.040). These results support the use of HDT/ASCT consolidation in CR1 for PTCL patients. Prospective randomized trials are necessary to confirm the efficacy of this approach.
外周 T 细胞淋巴瘤（PTCL）的常规治疗预后较差。我们回顾性分析了 1990 年至 2008 年在本中心接受大剂量化疗和自体造血干细胞移植（HDT/ASCT）治疗的 45 例 PTCL 患者的数据。18 例患者在诱导化疗完全缓解（CR1）后接受 HDT/ASCT，27 例患者在其他疾病状态下接受 HDT/ASCT。存活患者的中位随访时间为 113.5 个月（52.6-261.0）。5 年总生存率（OS）和无进展生存率（PFS）分别为 64%和 60%。CR1 组和其他疾病状态组的 5 年 OS 分别为 89%和 47%（P = 0.002），5 年 PFS 分别为 83%和 43%（P = 0.007）。在排除间变大细胞淋巴瘤的亚组中，CR1 移植患者的 5 年 OS（82%比 37%，P = 0.009）和 PFS（82%比 33%，P = 0.008）也显著优于其他疾病状态移植患者。多因素分析显示，CR1 状态是 OS（P = 0.040）和 PFS（P = 0.040）的唯一显著预后因素。这些结果支持在 CR1 状态下对 PTCL 患者进行 HDT/ASCT 巩固治疗。需要前瞻性随机试验来证实这种方法的疗效。
