Bo Jian, Zhao Yu, Zhang Songsong, Hua Wenrong, Wang Shuhong, Gao Chunji, Wang Quanshun, Li Honghua, Yu Li
Department of Hematology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
J Cancer Res Ther. 2016 Jul-Sep;12(3):1189-1197. doi: 10.4103/0973-1482.189235.
In this study, to investigate clinical characteristics, response, outcome, and prognosis of peripheral blood stem cell transplantation (PBSCT) for patients with peripheral T-cell lymphoma (PTCL).
This study retrospectively analyzed the efficacy of PBSCT in 38 patients with PTCL. Kaplan-Meier methods were used in survival analysis, and the Cox regression model was applied in multivariate analysis. There were ten clinical parameters were analyzed.
The 2-year overall survival (OS) was 46%, and the 5-year OS was 34% after a median follow-up of 40 months. The patients who received allogeneic PBSCT (allo-PBSCT) had a higher nonrelapse mortality than autologous PBSCT (auto-PBSCT), but they could achieve a longer-term disease-free survival in the former, which OS could achieve 40%. Survival analysis with Kaplan-Meier method showed the pretransplant disease status, B symptoms, serum lactate dehydrogenase (LDH) in early (>275 U/L), Eastern Cooperative Oncology Group (ECOG) score (>1), prognostic index for PTCL score (>2) were all prognostic factors for posttransplant OS. Pretransplant disease status is the only prognostic factor for allo-PBSCT.
The key was to reducing transplant-related mortality of allo-PBSCT by reduced-intensity conditioning. Factors such as level of early serum LDH, extranodal involvement, B symptoms, ECOG score, Ann Arbor stage, and pretransplant disease status were all related to the prognosis of patients treated with PBSCT. Allo-PBSCT maybe suggested as the first line therapy for late-stage PTCL patients who could reach treatment remission before transplantation.
本研究旨在探讨外周血干细胞移植(PBSCT)治疗外周T细胞淋巴瘤(PTCL)患者的临床特征、反应、结局和预后。
本研究回顾性分析了38例PTCL患者接受PBSCT的疗效。生存分析采用Kaplan-Meier方法,多因素分析应用Cox回归模型。分析了10个临床参数。
中位随访40个月后,2年总生存率(OS)为46%,5年OS为34%。接受异基因PBSCT(allo-PBSCT)的患者非复发死亡率高于自体PBSCT(auto-PBSCT),但前者可实现更长时间的无病生存,其OS可达40%。Kaplan-Meier方法进行的生存分析显示,移植前疾病状态、B症状、早期血清乳酸脱氢酶(LDH)(>275 U/L)、东部肿瘤协作组(ECOG)评分(>1)、PTCL预后指数评分(>2)均为移植后OS的预后因素。移植前疾病状态是allo-PBSCT的唯一预后因素。
关键在于通过减低预处理强度降低allo-PBSCT的移植相关死亡率。早期血清LDH水平、结外受累、B症状、ECOG评分、Ann Arbor分期和移植前疾病状态等因素均与接受PBSCT治疗患者的预后相关。对于移植前能达到治疗缓解的晚期PTCL患者,allo-PBSCT可能建议作为一线治疗。