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淋巴细胞性淋巴瘤的干细胞移植结果

Stem cell transplantation outcomes in lymphoblastic lymphoma.

作者信息

Brammer Jonathan E, Khouri Issa, Marin David, Ledesma Celina, Rondon Gabriela, Ciurea Stefan O, Nieto Yago, Champlin Richard E, Hosing Chitra, Kebriaei Partow

机构信息

a Department of Stem Cell Transplantation and Cellular Therapy , The University of Texas MD Anderson Cancer Center , Houston , TX , USA.

出版信息

Leuk Lymphoma. 2017 Feb;58(2):366-371. doi: 10.1080/10428194.2016.1193860. Epub 2016 Jun 27.

Abstract

Lymphoblastic lymphoma (LBL) is an aggressive lymphoma pathologically similar to lymphoblastic leukemia, but primarily presents with nodal or extra-medullary involvement. The aim of this study is to describe outcomes of patients undergoing stem cell transplantation (SCT) for LBL compared to historical data. Thirty-nine patients, of which 54% lacked complete remission (CR), received SCT for LBL between 1990 and 2015; 31 allogeneic and eight autologous. Overall survival (OS) and progression free survival (PFS) at three years for the entire cohort was 41%, the cumulative incidence (CI) of non-relapse mortality (NRM) was 18% at one year, and CI relapse mortality was 28% at one-year and 36% at three years; results similar to historical reports. On multivariate analysis, the use of total-body irradiation (TBI) based conditioning and transplantation in CR were independently predictive of OS and PFS. For patients requiring SCT for LBL, CR and TBI-based conditioning prior to allogeneic SCT may provide improved disease control.

摘要

淋巴母细胞淋巴瘤(LBL)是一种侵袭性淋巴瘤,病理上与淋巴母细胞白血病相似,但主要表现为淋巴结或髓外受累。本研究的目的是描述与历史数据相比,接受干细胞移植(SCT)治疗LBL的患者的预后。1990年至2015年间,39例LBL患者接受了SCT,其中54%未达到完全缓解(CR);31例接受异基因移植,8例接受自体移植。整个队列三年的总生存率(OS)和无进展生存率(PFS)为41%,一年时非复发死亡率(NRM)的累积发生率(CI)为18%,一年时CI复发死亡率为28%,三年时为36%;结果与历史报告相似。多因素分析显示,基于全身照射(TBI)的预处理和在CR时进行移植可独立预测OS和PFS。对于需要SCT治疗LBL的患者,CR以及异基因SCT前基于TBI的预处理可能会改善疾病控制。

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