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自体造血干细胞移植治疗晚期/复发鼻型结外NK/T细胞淋巴瘤的临床分析

[Clinical analysis of autologous hematopoietic stem cell transplantation in the treatment of advanced/recurrent nasal type extranodal NK/T-cell lymphoma].

作者信息

Yuan F F, Yin Q S, Fu Y W, Wang Q, Chen L, Mi R H, Li Y F, Wei X D, Song Y P

机构信息

Department of Hematology, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2018 Jul 14;39(7):569-572. doi: 10.3760/cma.j.issn.0253-2727.2018.07.008.

Abstract

To analyze the efficacy and safety of asparaginase based chemotherapy bridging autologous hematopoietic stem cell transplantation (auto-HSCT) in the treatment of 16 patients with nasal type extranodal NK/T-cell lymphoma (ENKTL). From January 2012 to June 2017, 16 patients with nasal type extranodal NK/T-cell lymphoma reached complete remission by L-asparaginase based regimens, and then received auto-HSCT. ①Of the 16 patients, 12 were males and 4 females, with a median age of 35.5 (14-61) years. There were 11 patients in the first complete remission (CR1) and 5 in the second CR (CR2) before transplantation, respectively. EB virus (EBV) DNA (EBV-DNA) was negative and positive in 13 and 3 cases respectively before transplantation. ②Hematopoietic reconstitution was achieved in all 16 cases. The median time for neutrophils implantation was 12 (8-17) days, and that of platelet implantation was 15.5 (12-24) days. ③To the last follow-up, there were no transplant related deaths, 3 patients died of disease progression. The median overall survival (OS) time and progression-free survival time (PFS) were not reached. Seven patients lived with no disease progression more than 2 years. ④The OS and PFS of patients at CR(1) before auto-HSCT are better than that of patients at CR(2), but there was no statistically significant difference (=0.162, =0.123). There was no significant difference in OS and PFS between EBV-DNA negative and positive patients before transplantation (=0.280, =0.244). L-asparaginase based regimens bridging auto-HSCT is a safe and highly effective for advanced-stage and relapsed ENKTL treatment.

摘要

分析以天冬酰胺酶为基础的化疗桥接自体造血干细胞移植(auto-HSCT)治疗16例鼻型结外NK/T细胞淋巴瘤(ENKTL)患者的疗效及安全性。2012年1月至2017年6月,16例鼻型结外NK/T细胞淋巴瘤患者经基于L-天冬酰胺酶的方案达到完全缓解,随后接受auto-HSCT。①16例患者中,男性12例,女性4例,中位年龄35.5(14 - 61)岁。移植前处于首次完全缓解(CR1)的患者有11例,处于第二次完全缓解(CR2)的患者有5例。移植前EB病毒(EBV)DNA(EBV-DNA)阴性者13例,阳性者3例。②16例患者均实现造血重建。中性粒细胞植入的中位时间为12(8 - 17)天,血小板植入的中位时间为15.5(12 - 24)天。③至末次随访时,无移植相关死亡,3例患者死于疾病进展。中位总生存(OS)时间和无进展生存时间(PFS)未达到。7例患者无疾病进展生存超过2年。④auto-HSCT前处于CR(1)的患者的OS和PFS优于处于CR(2)的患者,但差异无统计学意义(=0.162,=0.123)。移植前EBV-DNA阴性和阳性患者的OS和PFS差异无统计学意义(=0.280,=0.244)。基于L-天冬酰胺酶的方案桥接auto-HSCT治疗晚期及复发ENKTL安全且高效。

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