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接受大剂量治疗和自体干细胞移植的复发性霍奇金淋巴瘤儿童及青少年的治疗结果:纪念斯隆凯特琳癌症中心的经验

Outcome of children and adolescents with relapsed Hodgkin lymphoma treated with high-dose therapy and autologous stem cell transplantation: the Memorial Sloan Kettering Cancer Center experience.

作者信息

Giulino-Roth Lisa, O'Donohue Tara, Chen Zhengming, Trippett Tanya M, Klein Elizabeth, Kernan Nancy A, Kobos Rachel, Prockop Susan E, Scaradavou Andromachi, Shukla Neerav, Steinherz Peter G, Moskowitz Alison J, Moskowitz Craig H, Boulad Farid

机构信息

a Department of Pediatrics , Weill Cornell Medical College , New York , NY , USA.

b Department of Pediatrics , Memorial Sloan Kettering Cancer Center , New York , NY , USA.

出版信息

Leuk Lymphoma. 2018 Aug;59(8):1861-1870. doi: 10.1080/10428194.2017.1403601. Epub 2017 Nov 29.

Abstract

To evaluate outcomes and prognostic markers among children with relapsed Hodgkin lymphoma (HL) treated with autologous stem cell transplant (ASCT), we conducted a retrospective analysis of 36 consecutive pediatric patients treated at Memorial Sloan Kettering Cancer Center from 1989 to 2013. With a median follow-up of 9.6 years, the 10-year overall survival (OS) and event-free survival (EFS) were 74.1 and 67.1% respectively. Absence of B-symptoms, chemotherapy-sensitive disease, and transplant date after 1997 were each associated with superior EFS [HR 0.12 (p = .0015), 0.18 (p = .0039), and 0.17 (p = .0208), respectively]. Childhood Hodgkin International Prognostic Score at relapse (R-CHIPS) was calculated in a subset of patients (n = 22) and a lower score was associated with improved OS (HR 0.29, p = .0352) and a trend toward improved EFS (HR 0.38, p = .0527). In summary, ASCT results in durable remission for the majority of pediatric patients with relapsed HL. R-CHIPS should be evaluated in larger cohorts as a potential predictive tool.

摘要

为了评估接受自体干细胞移植(ASCT)治疗的复发性霍奇金淋巴瘤(HL)患儿的治疗结果和预后标志物,我们对1989年至2013年在纪念斯隆凯特琳癌症中心接受治疗的36例连续儿科患者进行了回顾性分析。中位随访时间为9.6年,10年总生存率(OS)和无事件生存率(EFS)分别为74.1%和67.1%。无B症状、化疗敏感疾病以及1997年后的移植日期均与较高的EFS相关[风险比(HR)分别为0.12(p = 0.0015)、0.18(p = 0.0039)和0.17(p = 0.0208)]。在一部分患者(n = 22)中计算了复发时的儿童霍奇金国际预后评分(R-CHIPS),较低的评分与改善的OS(HR 0.29,p = 0.0352)以及EFS改善趋势相关(HR 0.38,p = 0.0527)。总之,ASCT可使大多数复发性HL儿科患者获得持久缓解。R-CHIPS应在更大队列中作为潜在的预测工具进行评估。

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