Szcześniak Magdalena, Armatys Anna, Kurzawa Rafał, Kandzia Tomasz, Kozioł Dominika, Frankiewicz Andrzej, Kopińska Anna, Krawczyk-Kuliś Małgorzata, Kyrcz-Krzemień Sławomira, Helbig Grzegorz
Students' Research Group, Department of Hematology and Bone Marrow Transplantation, Silesian Medical University, Katowice, Poland.
Department of Hematology and Bone Marrow Transplantation, Silesian Medical University, Katowice, Poland.
Contemp Oncol (Pozn). 2013;17(5):456-9. doi: 10.5114/wo.2013.37223. Epub 2013 Oct 11.
Mantle cell lymphoma (MCL) is a B-cell neoplasm showing resistance to conventional chemotherapy. High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) may result in higher progression-free (PFS) and overall survival (OS) when used as a consolidation for younger and fit patients.
We retrospectively evaluated the results of ASCT for MCL. Patients were transplanted after achieving first or subsequent complete or partial response after conventional chemotherapy.
Twenty patients (7 male and 13 female) at median age of 59 years (range 41-68) were included. 90% of transplanted patients had stage III/IV disease at diagnosis and low, intermediate and high MIPI scores occurred in 5, 9 and 6 patients respectively. Induction chemotherapy consisted of the R-CHOP regimen in all patients except one who received R-CVAD. The disease status at transplant was as follows: first complete response (n = 13); second complete response (n = 4) and partial response (n = 3). The conditioning regimen prior to ASCT consisted of CBV and BEAM for 18 and 2 patients, respectively. The transplant-related mortality was 0% at day 100. Median OS and PFS were 48 and 29.8 months, respectively. The estimated 5-year OS and PFS were found to be 52% and 35%, respectively. After median follow-up after ASCT of 36 months (range 11-73), 10 patients were alive with 8 remaining in complete remission (CR) whereas 2 relapsed and received salvage chemotherapy. Ten patients died from disease recurrence and subsequent chemoresistance.
ASCT as a consolidation for MCL patients is found to be an effective and safe procedure.
套细胞淋巴瘤(MCL)是一种对传统化疗耐药的B细胞肿瘤。对于年轻且身体状况良好的患者,高剂量化疗后进行自体干细胞移植(ASCT)作为巩固治疗可能会带来更高的无进展生存期(PFS)和总生存期(OS)。
我们回顾性评估了MCL患者ASCT的结果。患者在传统化疗后达到首次或后续完全缓解或部分缓解后接受移植。
纳入了20例患者(7例男性和13例女性),中位年龄为59岁(范围41 - 68岁)。90%的移植患者在诊断时处于III/IV期疾病,低、中、高MIPI评分分别出现在5例、9例和6例患者中。除1例接受R - CVAD方案外,所有患者的诱导化疗均采用R - CHOP方案。移植时的疾病状态如下:首次完全缓解(n = 13);第二次完全缓解(n = 4)和部分缓解(n = 3)。ASCT前的预处理方案中,分别有18例和2例患者采用CBV和BEAM方案。100天时移植相关死亡率为0%。中位OS和PFS分别为48个月和29.8个月。估计5年OS和PFS分别为52%和35%。ASCT后中位随访36个月(范围11 - 73个月),10例患者存活,其中8例仍处于完全缓解(CR)状态,2例复发并接受挽救性化疗。10例患者死于疾病复发及后续化疗耐药。
ASCT作为MCL患者的巩固治疗是一种有效且安全的方法。