Atesoglu Elif Birtas, Hacıhanefioglu Abdullah, Gulbas Zafer
Department of Hematology, Kocaeli University, Kocaeli, Turkey.
Bone Marrow Transplantation Center, Anadolu Medical Center Hospital, Kocaeli, Turkey.
Transfus Apher Sci. 2015 Feb;52(1):65-71. doi: 10.1016/j.transci.2014.12.007. Epub 2014 Dec 18.
Autologous stem cell transplantation (ASCT) is an established therapeutic modality in the treatment of lymphomas, especially in the relapse setting. In the present study, we aimed to define pretransplantation factors including Beta-2 microglobulin (β2m) that influence outcomes following ASCT in patients with non-Hodgkin lymphoma (NHL). We analyzed retrospectively 78 NHL patients who had undergone ASCT from August 2010 to January 2013. The 2-year overall survival (OS) was 70% and the progression-free survival (PFS) was 60%. While remission status less than complete remission (CR) emerged to be a poor prognostic factor for OS in univariate analysis, high β2m levels and comorbidity indices revealed to be independent poor risk factors for both OS and PFS. The present study demonstrated that even if the patient is in CR before ASCT if he has high β2m, the 2-year OS decreases from 100% to 49%. Moreover, lymphopenia for the first time was demonstrated to predict PFS in ASCT in NHL patients. Our findings suggest that β2m at transplantation predict the outcome after ASCT in NHL and further investigation with larger sample sizes is warranted.
自体干细胞移植(ASCT)是治疗淋巴瘤,尤其是复发型淋巴瘤的一种成熟治疗方式。在本研究中,我们旨在确定包括β2微球蛋白(β2m)在内的移植前因素,这些因素会影响非霍奇金淋巴瘤(NHL)患者接受ASCT后的预后。我们回顾性分析了2010年8月至2013年1月期间接受ASCT的78例NHL患者。2年总生存率(OS)为70%,无进展生存率(PFS)为60%。在单因素分析中,缓解状态低于完全缓解(CR)是OS的不良预后因素,而高β2m水平和合并症指数是OS和PFS的独立不良风险因素。本研究表明,即使患者在ASCT前处于CR状态,但如果其β2m水平高,2年OS会从100%降至49%。此外,首次证明淋巴细胞减少可预测NHL患者ASCT后的PFS。我们的研究结果表明,移植时的β2m可预测NHL患者ASCT后的预后,有必要进行更大样本量的进一步研究。