Department of Radiation Oncology, University Hospital (UH) of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
Department of Internal Medicine II, University Hospital of Tübingen, Tübingen, Germany.
J Cancer Res Clin Oncol. 2018 Jun;144(6):1173-1183. doi: 10.1007/s00432-018-2633-5. Epub 2018 Apr 5.
In patients with follicular lymphoma, secondary transformation to aggressive lymphoma (tFL) implies a poor prognosis. In principle, allogeneic haematopoietic cell transplantation (allo-HCT) offers a chance of cure for tFL but is rarely practiced. Aim of this retrospective multicenter study was to define the actual significance of allo-HCT in treatment of tFL.
The database of the German Registry for Stem Cell Transplantation (DRST) was screened for patients who underwent allo-HCT for tFL 1998-2008. Confirmation of tFL-diagnosis by local and/or pathologists of the National NHL Board was mandatory for enrolment. Gaps in reported EBMT Minimum Essential Data datasets (MED-A) were filled by local DRST data managers. Relevant HCT outcome variables were evaluated by uni- and multivariate statistical analysis.
Median age of enrolled 33 patients was 51 years with a post allo-HCT median follow-up of 7.1 years of surviving patients. At time of HCT 24/33 patients had chemosensitive disease. In 24/33 patients reduced intensity conditioning (RIC) was used. Estimated 1, 2, 5-year overall survival (OS) and event-free survival rates were 49/39/33, and 33/30/24%. Cumulative 100 days non-relapse mortality was 25%. Chemosensitive disease, RIC, and limited chronic GvHD were identified as independent prognostic factors for OS.
Allo-HCT offers the chance of cure for tFL.
在滤泡性淋巴瘤患者中，继发转化为侵袭性淋巴瘤（tFL）意味着预后不良。原则上，异基因造血细胞移植（allo-HCT）为 tFL 提供了治愈的机会，但很少实施。本回顾性多中心研究的目的是确定 allo-HCT 在 tFL 治疗中的实际意义。
筛选了 1998 年至 2008 年期间接受 allo-HCT 治疗 tFL 的德国干细胞移植登记处（DRST）数据库。当地和/或国家 NHL 委员会的病理学家必须确认 tFL 诊断，方可入组。EBMT 最低基本数据数据集（MED-A）中报告的缺失数据由当地 DRST 数据管理员填补。通过单变量和多变量统计分析评估相关 HCT 结局变量。
纳入的 33 例患者的中位年龄为 51 岁，接受 allo-HCT 后的中位随访时间为幸存患者的 7.1 年。在 HCT 时，24/33 例患者有化疗敏感疾病。在 33 例患者中使用了强度降低的预处理方案（RIC）。估计 1、2、5 年总生存率（OS）和无事件生存率分别为 49/39/33 和 33/30/24%。累积 100 天非复发死亡率为 25%。化疗敏感疾病、RIC 和有限的慢性移植物抗宿主病被确定为 OS 的独立预后因素。
allo-HCT 为 tFL 提供了治愈的机会。
