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淋巴瘤异基因造血干细胞移植的疗效:单中心经验

Outcomes of allogeneic hematopoietic stem cell transplantation for lymphomas: a single-institution experience.

作者信息

Massoud Mira Romany, Caimi Paolo Fabrizio, Ferrari Nicole, Fu Pingfu, Creger Richard, Fox Robert, Carlson-Barko Joanne, Kolk Merle, Brister Lauren, Cooper Brenda Wimpfheimer, Gerson Stanton, Lazarus Hillard Michael, de Lima Marcos, William Basem Magdy

机构信息

University Hospitals Case Medical Center, Cleveland, United States.

University Hospitals Case Medical Center, Cleveland, United States; Case Western Reserve University, Cleveland, United States.

出版信息

Rev Bras Hematol Hemoter. 2016 Oct-Dec;38(4):314-319. doi: 10.1016/j.bjhh.2016.07.003. Epub 2016 Aug 18.

Abstract

INTRODUCTION

Allogeneic hematopoietic stem cell transplantation offers the opportunity for extended survival in patients with Hodgkin's and non-Hodgkin lymphomas who relapsed after, or were deemed ineligible for, autologous transplantation. This study reports the cumulative experience of a single center over the past 14 years aiming to define the impact of patient, disease, and transplant-related characteristics on outcomes.

METHODS

All patients with histologically confirmed diagnosis of Hodgkin's or non-Hodgkin lymphomas who received allogeneic transplantation from 2000 to 2014 were retrospectively studied.

RESULTS

Forty-one patients were reviewed: 10 (24%) had Hodgkin's and 31 (76%) had non-Hodgkin lymphomas. The median age was 50 years and 23 (56%) were male. The majority of patients (68%) had had a prior autologous transplantation. At the time of allogeneic transplantation, 18 (43%) patients were in complete and seven (17%) were in partial remission. Most (95%) patients received reduced-intensity conditioning, 49% received matched sibling donor grafts, 24% matched-unrelated donor grafts, and 27% received double umbilical cord blood grafts. The 100-day treatment-related mortality rate was 12%. After a median duration of follow up of 17.1 months, the median progression-free and overall survival was 40.5 and 95.8 months, respectively. On multivariate analysis, patients who had active disease at the time of transplant had inferior survival.

CONCLUSIONS

Allogeneic transplantation results extend survival in selected patients with relapsed/refractory Hodgkin's and non-Hodgkin lymphomas with low treatment-related mortality. Patients who have active disease at the time of allogeneic transplantation have poor outcomes.

摘要

引言

异基因造血干细胞移植为霍奇金淋巴瘤和非霍奇金淋巴瘤患者提供了延长生存期的机会,这些患者在自体移植后复发或被认为不适合自体移植。本研究报告了一个单一中心在过去14年的累积经验,旨在确定患者、疾病和移植相关特征对预后的影响。

方法

对2000年至2014年接受异基因移植的所有组织学确诊为霍奇金淋巴瘤或非霍奇金淋巴瘤的患者进行回顾性研究。

结果

共回顾了41例患者:10例(24%)为霍奇金淋巴瘤,31例(76%)为非霍奇金淋巴瘤。中位年龄为50岁,23例(56%)为男性。大多数患者(68%)曾接受过自体移植。在进行异基因移植时,18例(43%)患者处于完全缓解期,7例(17%)处于部分缓解期。大多数(95%)患者接受了减低强度预处理,49%接受了同胞全相合供体移植,24%接受了非血缘全相合供体移植,27%接受了双份脐血移植。100天治疗相关死亡率为12%。中位随访时间为17.1个月后,无进展生存期和总生存期的中位数分别为40.5个月和95.8个月。多因素分析显示,移植时患有活动性疾病的患者生存率较低。

结论

异基因移植可延长部分复发/难治性霍奇金淋巴瘤和非霍奇金淋巴瘤患者的生存期,且治疗相关死亡率较低。异基因移植时患有活动性疾病的患者预后较差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c343/5119668/7946605c8685/gr1.jpg

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本文引用的文献

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