首次异基因移植后淋巴瘤复发患者的第二次异基因造血干细胞移植。欧洲血液与骨髓移植协会淋巴瘤工作组的一项回顾性研究。
Second allo-SCT in patients with lymphoma relapse after a first allogeneic transplantation. A retrospective study of the EBMT Lymphoma Working Party.
作者信息
Horstmann K, Boumendil A, Finke J, Finel H, Kanfer E, Milone G, Russell N, Bacigalupo A, Chalandon Y, Diez-Martin J L, Ifrah N, Chacon M Jurado, Dreger P
机构信息
1] EBMT Lymphoma Working Party, Paris, France [2] Department of Medicine V, University of Heidelberg, Heidelberg, Germany.
EBMT Lymphoma Working Party, Paris, France.
出版信息
Bone Marrow Transplant. 2015 Jun;50(6):790-4. doi: 10.1038/bmt.2015.12. Epub 2015 Mar 9.
The aim of this registry-based retrospective study was to analyze the outcome of second allogeneic hematopoietic SCT (alloHSCT_2) performed in patients with lymphoma who had relapsed after a first allogeneic transplant (alloHSCT_1). Patients ⩾18 years who had received an alloHSCT_2 for lymphoma relapse between 2000 and 2011 were eligible. One hundred and forty patients were identified. The diagnosis was Hodgkin lymphoma (HL) in 31%, diffuse large B-cell lymphoma in 14%, T-cell lymphoma in 12%, indolent lymphoma in 19%, mantle cell lymphoma in 16% and other lymphomas in 8% of the patients. The median interval from alloHSCT_1 to alloHSCT_2 was 19 (range 4-116) months. Disease status at alloHSCT_2 was chemosensitive in 46%, refractory in 43% and unknown in 11% of the patients. Three-year PFS, OS, relapse incidence and nonrelapse mortality were 19%, 29%, 58% and 23%, respectively. PFS and OS were significantly affected by refractory disease at alloHSCT_2 and a short interval between alloHSCT_1 and alloHSCT_2. Long-term PFS was observed across all lymphoma subsets except for aggressive B-cell lymphoma. In conclusion, alloHSCT_2 is feasible and can result in long-term disease control in patients with lymphoma recurrence after alloHSCT_1, in particular if relapse occurs late and is chemosensitive.
这项基于登记处的回顾性研究旨在分析首次异基因造血干细胞移植（alloHSCT_1）后复发的淋巴瘤患者接受第二次异基因造血干细胞移植（alloHSCT_2）的结局。纳入2000年至2011年间因淋巴瘤复发接受alloHSCT_2且年龄≥18岁的患者。共确定了140例患者。诊断为霍奇金淋巴瘤（HL）的患者占31%，弥漫性大B细胞淋巴瘤占14%，T细胞淋巴瘤占12%，惰性淋巴瘤占19%，套细胞淋巴瘤占16%，其他淋巴瘤占8%。从alloHSCT_1到alloHSCT_2的中位间隔时间为19（4 - 116）个月。alloHSCT_2时的疾病状态，46%的患者化疗敏感，43%难治，11%未知。三年无进展生存期（PFS）、总生存期（OS）、复发率和非复发死亡率分别为19%、29%、58%和23%。alloHSCT_2时的难治性疾病以及alloHSCT_1和alloHSCT_2之间的间隔时间短对PFS和OS有显著影响。除侵袭性B细胞淋巴瘤外，在所有淋巴瘤亚组中均观察到长期PFS。总之，alloHSCT_2是可行的，并且可使alloHSCT_1后复发的淋巴瘤患者实现长期疾病控制，特别是如果复发发生较晚且化疗敏感。
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