Yano S, Mori T, Kanda Y, Kato J, Nakaseko C, Fujisawa S, Tomita N, Sakai R, Shono K, Saitoh T, Aotsuka N, Kobayashi N, Saito T, Takahashi S, Kanamori H, Okamoto S
Division of Clinical Oncology and Hematology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan.
Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Bone Marrow Transplant. 2015 Oct;50(10):1299-305. doi: 10.1038/bmt.2015.158. Epub 2015 Jul 13.
Allogeneic stem cell transplantation (allo-SCT) is a curative option for patients with relapsed follicular lymphoma (FL). Prospective studies of reduced-intensity conditioning (RIC) have revealed that chemosensitivity at allo-SCT is the most reliable predictor of outcome; however, limited data are available for progressive/refractory disease. We report here a retrospective analysis of RIC allo-SCT for patients with FL. The purpose of this study was to elucidate the role of allo-SCT for patients with relapsed/refractory FL. We analyzed 46 patients-11 (24%) transplanted in CR, 6 (13%) transplanted in PR and 29 (63%) with progressive/refractory disease. The estimated 5-year overall survival rate was 71.6% (95% confidence interval (CI), 51.5-84.5%). According to the disease status at transplantation, the 5-year survival rate was 80.7% (95% CI, 37.7-95.4%) in the patients with CR or PR and 66.1% (95% CI, 41.5-82.3%) in those with progressive/refractory disease (P=0.29). There were no differences in relapse/progression and non-relapse mortality between the patients with chemosensitive disease and progressive/refractory disease. Allo-SCT may be a valuable treatment option, even for patients with progressive/refractory FL.
异基因干细胞移植(allo-SCT)是复发滤泡性淋巴瘤(FL)患者的一种治愈性选择。降低强度预处理(RIC)的前瞻性研究表明,allo-SCT时的化疗敏感性是最可靠的预后预测指标;然而,关于进展性/难治性疾病的数据有限。我们在此报告一项针对FL患者的RIC allo-SCT回顾性分析。本研究的目的是阐明allo-SCT对复发/难治性FL患者的作用。我们分析了46例患者,其中11例(24%)在完全缓解(CR)时进行移植,6例(13%)在部分缓解(PR)时进行移植,29例(63%)患有进展性/难治性疾病。估计5年总生存率为71.6%(95%置信区间(CI),51.5 - 84.5%)。根据移植时的疾病状态,CR或PR患者的5年生存率为80.7%(95%CI,37.7 - 95.4%),进展性/难治性疾病患者的5年生存率为66.1%(95%CI,41.5 - 82.3%)(P = 0.29)。化疗敏感疾病患者与进展性/难治性疾病患者在复发/进展和非复发死亡率方面无差异。allo-SCT可能是一种有价值的治疗选择,即使对于进展性/难治性FL患者也是如此。