Kitahara Hideaki, Maruyama Dai, Maeshima Akiko Miyagi, Makita Shinichi, Miyamoto Ken-Ichi, Fukuhara Suguru, Munakata Wataru, Suzuki Tatsuya, Kobayashi Yukio, Tajima Kinuko, Terauchi Takashi, Kurihara Hiroaki, Taniguchi Hirokazu, Komatsu Norio, Tobinai Kensei
Department of Hematology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan.
Ann Hematol. 2017 Mar;96(3):411-420. doi: 10.1007/s00277-016-2891-8. Epub 2016 Dec 7.
Cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP)/CHOP-like chemotherapy has been mostly applied to patients with untreated peripheral T cell lymphoma (PTCL). Because the long-term outcome of patients with PTCL, especially those achieving complete response (CR), has not been fully elucidated, we retrospectively analyzed 78 consecutive patients initially treated with CHOP/CHOP-like chemotherapy, without high-dose chemotherapy followed by autologous stem cell transplantation (HDC/auto-SCT). Median overall and progression-free survivals in all 78 patients were 44 and 17 months, respectively, with a median follow-up of 62 months. In the 53 patients achieving CR, the median relapse-free survival (RFS) was 21 months, and 2-, 3-, and 5-year RFSs were 46, 45, and 36%, respectively. Although our results showed an unfavorable outcome for PTCL as a whole, those who achieved CR following CHOP/CHOP-like chemotherapy did not always have a poor outcome without the consolidation of HDC/auto-SCT; in particular, 45% of the 65 years or younger patients were alive without disease at 5 years.
环磷酰胺、阿霉素、长春新碱和泼尼松(CHOP)/类CHOP化疗主要应用于未经治疗的外周T细胞淋巴瘤(PTCL)患者。由于PTCL患者的长期预后,尤其是那些达到完全缓解(CR)的患者,尚未完全阐明,我们回顾性分析了78例连续接受CHOP/类CHOP化疗初始治疗的患者,未进行高剂量化疗后自体干细胞移植(HDC/auto-SCT)。所有78例患者的中位总生存期和无进展生存期分别为44个月和17个月,中位随访时间为62个月。在53例达到CR的患者中,中位无复发生存期(RFS)为21个月,2年、3年和5年RFS分别为46%、45%和36%。虽然我们的结果显示PTCL总体预后不佳,但那些在CHOP/类CHOP化疗后达到CR的患者,在没有HDC/auto-SCT巩固治疗的情况下,并不总是预后不良;特别是,65岁及以下患者中有45%在5年时无病存活。