Department of Paediatrics, National Kyushu Cancer Centre, Fukuoka, Japan.
Br J Haematol. 2015 Feb;168(4):557-63. doi: 10.1111/bjh.13167. Epub 2014 Oct 14.
To evaluate haematopoietic stem cell transplantation (HSCT) in children and adolescents, we reviewed the records of 47 patients who were ≤18 years, had relapsed or refractory anaplastic large cell lymphoma, and received HSCT between 1990 and 2010. At HSCT, complete remission (CR) was less common in allogeneic HSCT recipients (n = 24) than in autologous HSCT recipients (n = 23) (P = 0·01). The autologous and allogeneic HSCT groups differed in terms of 5-year event-free survival (EFS) (38% vs. 50%, P = 0·63), cumulative incidence of progress or relapse (49% vs. 28%, P = 0·25), and treatment-related mortality (12% vs. 25%, P = 0·40). However, these differences were not significant. Patients with non-CR at autologous HSCT had a significantly lower EFS rate (14% vs. 48%, P = 0·03). Conversely, although those with non-CR at allogeneic HSCT had a lower EFS rate, this was not significant (44% vs. 63%, P = 0·26). Reduced-intensity conditioning regimens were used for three of the 16 allogeneic HSCTs received by patients with non-CR. These three patients achieved CR, surviving 32-65 months after HSCT. These results demonstrated that allogeneic HSCT might be a treatment option for patients who do not achieve CR through conventional chemotherapy.
为了评估儿童和青少年造血干细胞移植（HSCT）的效果，我们回顾了 1990 年至 2010 年间接受 HSCT 的 47 例≤18 岁、复发或难治性间变大细胞淋巴瘤患者的记录。在 HSCT 时，异体 HSCT 受者（n=24）完全缓解（CR）的比例明显低于自体 HSCT 受者（n=23）（P=0·01）。自体和异体 HSCT 两组在 5 年无事件生存率（EFS）（38%比 50%，P=0·63）、进展或复发累积发生率（49%比 28%，P=0·25）和治疗相关死亡率（12%比 25%，P=0·40）方面存在差异，但无统计学意义。自体 HSCT 时未达 CR 的患者 EFS 率显著降低（14%比 48%，P=0·03）。相反，虽然异体 HSCT 时未达 CR 的患者 EFS 率较低，但无统计学意义（44%比 63%，P=0·26）。3 例未达 CR 的异体 HSCT 患者接受了强度降低的预处理方案，这 3 例患者均达到 CR，HSCT 后生存 32-65 个月。这些结果表明，对于未通过常规化疗达到 CR 的患者，异体 HSCT 可能是一种治疗选择。
