Robinson Stephen P, Boumendil Ariane, Finel Herve, Peggs Karl S, Chevallier Patrice, Sierra Jorge, Finke Jürgen, Poiré Xavier, Maillard Natacha, Milpied Noël, Yakoub-Agha Ibrahim, Koh Mickey, Kröger Nicolaus, Nagler Arnon, Koc Yener, Dietrich Sascha, Montoto Silvia, Dreger Peter
University Hospitals Bristol, Bristol, UK.
Lymphoma Working Party EBMT, Paris, France.
Bone Marrow Transplant. 2018 May;53(5):617-624. doi: 10.1038/s41409-017-0067-3. Epub 2018 Jan 15.
Reduced-intensity allogeneic stem cell transplantation (RIST) is usually reserved for patients with mantle cell lymphoma who relapse after an autoSCT. However, the long-term efficacy of RIST and its curative potential have not been clearly demonstrated. We studied the long-term outcome of patients receiving a RIST for MCL as reported to the EBMT. A total of 324 patients, median age 57 years (range 31-70), underwent a RIST between 2000 and 2008; 43% of the patients had received >3 lines of prior therapy, including an autoSCT in 46%. Non-relapse mortality (NRM) was 10% at 100 days and 24% at 1 year and was lower for patients receiving anti-thymocyte globulin (ATG)/ALG (RR 0.59, p = 0.046). After a median follow-up of 72 months (range 3-159), 118 patients relapsed at a median of 8 months post RIST (range 1-117). The cumulative incidence of relapse was 25% and 40% at 1 and 5 years, respectively, and was associated with chemorefractory disease (HR 0.49, p = 0.01) and the use of CAMPATH (HR 2.59, p = 0.0002). The 4-year progression-free survival rate and overall survival rate was 31 and 40%, respectively. RIST results in long-term disease-free survival in about 30% of the patients, including those patients relapsing after a prior autoSCT.
减低强度异基因干细胞移植（RIST）通常用于自体干细胞移植（autoSCT）后复发的套细胞淋巴瘤患者。然而，RIST的长期疗效及其治愈潜力尚未得到明确证实。我们研究了向欧洲血液与骨髓移植协会（EBMT）报告的接受RIST治疗套细胞淋巴瘤患者的长期结局。共有324例患者，中位年龄57岁（范围31 - 70岁），在2000年至2008年间接受了RIST；43%的患者接受过>3线的前期治疗，其中46%的患者接受过autoSCT。100天时非复发死亡率（NRM）为10%，1年时为24%，接受抗胸腺细胞球蛋白（ATG）/抗淋巴细胞球蛋白（ALG）的患者NRM较低（风险比RR 0.59，p = 0.046）。中位随访72个月（范围3 - 159个月）后，118例患者复发，中位复发时间为RIST后8个月（范围1 - 117个月）。1年和5年时的累积复发率分别为25%和40%，与化疗难治性疾病（风险比HR 0.49，p = 0.01）和使用CAMPATH（HR 2.59，p = 0.0002）相关。4年无进展生存率和总生存率分别为31%和40%。RIST使约30%的患者实现长期无病生存，包括那些先前autoSCT后复发的患者。
