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弥漫性大B细胞淋巴瘤一线自体干细胞移植后外周血绝对淋巴细胞计数早期恢复的临床影响

Clinical impact of early recovery of peripheral blood absolute lymphocyte count after frontline autologous stem cell transplantation for diffuse large B-cell lymphoma.

作者信息

Kim Yundeok, Kim Soo-Jeong, Cheong June-Won, Cho Hyunsoo, Chung Haerim, Lee Jung Yeon, Jang Ji Eun, Min Yoo Hong, Kim Jin Seok

机构信息

Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea.

出版信息

Hematol Oncol. 2017 Dec;35(4):465-471. doi: 10.1002/hon.2332. Epub 2016 Jul 21.

Abstract

We conducted a retrospective study to evaluate the clinical impact of an early recovery of posttransplant absolute lymphocyte count (ALC) on the outcome of frontline autologous stem cell transplantation (ASCT) for diffuse large B-cell lymphoma (DLBCL). We reviewed 65 DLBCL patients who underwent frontline ASCT after primary chemotherapy based on cyclophosphamide, doxorubicin, vincristine, and prednisone. A receiver operating characteristic analysis was performed to determine the optimal cut point (0.4 × 10 /L) for an ALC at 15 days after ASCT (ALC-15). Both event-free survival and overall survival rates of the higher-ALC-15 group were significantly better than those of the lower-ALC-15 group (event-free survival, P = .008; overall survival, P = .013). The infused CD34 cell count was significantly associated with the recovery of ALC-15 (>0.4 × 10 /L) after ASCT (P = .028). A multivariate analysis confirmed that a higher infused CD34 cell dose (>5.0 × 10  cells/kg) was an independent factor affecting an early recovery of ALC after ASCT (odds ratio, 4.145; 95% confidence interval, 1.106-15.528; P = .035). In conclusion, an early recovery of ALC after ASCT can be regarded as a good prognostic marker in patients with DLBCL who have undergone frontline ASCT. We found that the infused CD34 cell dose for ASCT was associated with the recovery of ALC.

摘要

我们进行了一项回顾性研究,以评估移植后绝对淋巴细胞计数(ALC)早期恢复对弥漫性大B细胞淋巴瘤(DLBCL)一线自体干细胞移植(ASCT)结局的临床影响。我们回顾了65例接受基于环磷酰胺、阿霉素、长春新碱和泼尼松的一线化疗后进行一线ASCT的DLBCL患者。进行了受试者工作特征分析,以确定ASCT后15天(ALC-15)时ALC的最佳切点(0.4×10⁹/L)。ALC-15较高组的无事件生存率和总生存率均显著优于ALC-15较低组(无事件生存率,P = 0.008;总生存率,P = 0.013)。输注的CD34细胞计数与ASCT后ALC-15(>0.4×10⁹/L)的恢复显著相关(P = 0.028)。多因素分析证实,较高的输注CD34细胞剂量(>5.0×10⁶细胞/kg)是影响ASCT后ALC早期恢复的独立因素(比值比,4.145;95%置信区间,1.106 - 15.528;P = 0.035)。总之,ASCT后ALC的早期恢复可被视为接受一线ASCT的DLBCL患者的良好预后标志物。我们发现ASCT的输注CD34细胞剂量与ALC的恢复有关。

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