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自体造血干细胞移植可能改善新诊断的鼻型结外自然杀伤/T细胞淋巴瘤患者的长期预后:一项单中心回顾性对照研究

Autologous hematopoietic stem cell transplantation may improve long-term outcomes in patients with newly diagnosed extranodal natural killer/T-cell lymphoma, nasal type: a retrospective controlled study in a single center.

作者信息

Wang Jingwen, Wei Liqiang, Ye Jin, Yang Lei, Li Xin, Cong Jia, Yao Na, Cui Xueying, Wu Yiping, Ding Jing, Zhang Le

机构信息

Department of Hematology, Beijing Tongren Hospital, Capital Medical University, Dong Jiao Min Xiang Street, No.1, Dong Cheng District, Beijing, 10073, China.

Beijing Key Laboratory of Head and Neck Molecular Diagnostic Pathology, Dong Jiao Min Xiang Street, No.1, Dong Cheng District, Beijing, 10073, China.

出版信息

Int J Hematol. 2018 Jan;107(1):98-104. doi: 10.1007/s12185-017-2324-z. Epub 2017 Aug 30.

Abstract

Extranodal natural killer/T-cell lymphoma, nasal type (ENKTL) is a rare disease with a poor prognosis. The long-term effect of autologous hematopoietic stem cell transplantation (auto-HSCT) on ENKTL has been reported occasionally but needs further investigation. In this retrospective study from a single center, 20 ENKTL patients who received induction chemotherapy followed by auto-HSCT ± involved-field radiotherapy (IFRT) ± additional chemotherapy were enrolled as a study group. Another 60 fit ENKTL patients who received induction chemotherapy ± IFRT ± additional chemotherapy were selected as the control group. Baseline characteristics of all patients were well balanced. Our analysis showed that after a median follow-up time of 61.0 months (95% CI 52.3-69.7), the auto-HSCT treated group showed better overall survival (OS) than the control group (p = 0.045). The median OS of the auto-HSCT-treated group was not reached, but that of the control group was 62.0 months. Five-year comparison of OS between the two groups also showed a significant difference (79.3 vs. 52.3%, p = 0.026). We suggest that auto-HSCT treatment, in combination with chemoradiotherapy, may prolong OS and improve the long-term outcomes of fit patients with ENKTL compared to treatment with chemoradiotherapy alone.

摘要

结外自然杀伤/T细胞淋巴瘤,鼻型(ENKTL)是一种预后较差的罕见疾病。自体造血干细胞移植(auto-HSCT)对ENKTL的长期影响虽偶有报道,但仍需进一步研究。在这项来自单一中心的回顾性研究中,20例接受诱导化疗后行auto-HSCT±累及野放疗(IFRT)±追加化疗的ENKTL患者被纳入研究组。另外60例接受诱导化疗±IFRT±追加化疗的合适ENKTL患者被选为对照组。所有患者的基线特征均衡良好。我们的分析显示,中位随访时间61.0个月(95%CI 52.3 - 69.7)后,auto-HSCT治疗组的总生存期(OS)优于对照组(p = 0.045)。auto-HSCT治疗组的中位OS未达到,但对照组为62.0个月。两组OS的5年比较也显示出显著差异(79.3%对52.3%,p = 0.026)。我们认为,与单纯放化疗相比,auto-HSCT联合放化疗可能会延长合适的ENKTL患者的OS并改善其长期预后。

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