Lamm Wolfgang, Wohlfarth Philipp, Bojic Marija, Schörgenhofer Christian, Kalhs Peter, Raderer Markus, Rabitsch Werner
Clinical Division of Oncology, Medical University of Vienna, Vienna, Austria.
Oncology. 2015;89(2):118-23. doi: 10.1159/000381101. Epub 2015 Apr 15.
Mantle cell lymphoma (MCL) is a B cell non-Hodgkin's lymphoma characterized by a poor prognosis. Many different therapeutic approaches including intensive chemotherapy as well as new targeted therapies are established. However, overall survival remains unsatisfying. As the sole curative option, allogeneic hematopoietic stem cell transplantation (HSCT) has been described, but only a limited number of patients qualify for this procedure. We have retrospectively analyzed 7 patients with stage IV MCL undergoing allogeneic HSCT at our institution. A myeloablative regimen was used in 1 patient, while the other 6 patients received reduced-intensity conditioning. Four patients had an HLA-identical sibling, and the remaining 3 patients had an HLA-identical unrelated donor. One patient developed acute graft-versus-host disease (skin, grade III; intestine, grade II). Two patients died from transplant-related causes, 3 patients died due to progressive disease and the remaining 2 patients are still in complete remission 147 and 8 months after transplantation. Allogeneic HSCT offers a therapeutic treatment option for selected patients in a relapsed/refractory setting. The incorporation of novel agents has improved the outcome of patients with MCL. Thus, the role and optimal time point of allogeneic HSCT should be reevaluated in randomized trials.
套细胞淋巴瘤（MCL）是一种预后较差的B细胞非霍奇金淋巴瘤。已经确立了许多不同的治疗方法，包括强化化疗以及新的靶向治疗。然而，总体生存率仍然不尽人意。作为唯一的治愈选择，同种异体造血干细胞移植（HSCT）已被报道，但只有少数患者符合该手术条件。我们回顾性分析了在我们机构接受同种异体HSCT的7例IV期MCL患者。1例患者采用了清髓性方案，而其他6例患者接受了减低强度预处理。4例患者有HLA相合的同胞供者，其余3例患者有HLA相合的无关供者。1例患者发生了急性移植物抗宿主病（皮肤，III级；肠道，II级）。2例患者死于移植相关原因，3例患者死于疾病进展，其余2例患者在移植后147个月和8个月仍处于完全缓解状态。同种异体HSCT为复发/难治性情况下的选定患者提供了一种治疗选择。新型药物的加入改善了MCL患者的预后。因此，应在随机试验中重新评估同种异体HSCT的作用和最佳时间点。
