Selberg Lorenz, Stadtherr Peter, Dietrich Sascha, Tran T Hien, Luft Thomas, Hegenbart Ute, Bondong Andrea, Meissner Julia, Liebers Nora, Schmitt Michael, Ho Anthony Dick, Müller-Tidow Carsten, Dreger Peter
Department Medicine V, University of Heidelberg, Heidelberg, Germany.
Institute of Immunology, University of Heidelberg, Heidelberg, Germany.
Bone Marrow Transplant. 2021 Jan;56(1):30-37. doi: 10.1038/s41409-020-0976-4. Epub 2020 Jun 18.
Purpose of this single-centre retrospective study was to assess the outcome of allogeneic hematopoietic cell transplantation (alloHCT) for relapsed/refractory (r/r) non-Hodgkin lymphoma (NHL) by intent-to-transplant (ITT). Included were all consecutive patients with diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), mantle cell lymphoma (MCL), and peripheral T-cell lymphoma (PTCL) for whom a donor search was performed between 2004 and 2018. Primary endpoint was overall survival (OS) measured from search initiation. A donor search was initiated for 189 patients (DLBCL 61, FL 32, MCL 43, and PTCL 53), with 76% of the patients having active disease. OS at 5 years after search initiation for DLBCL, FL, MCL, and PTCL was 26%, 44%, 52%, and 50%, respectively. AlloHCT was performed in 137 patients (72%; DLBCL 64%). Main reason for not undergoing alloHCT was disease progression, whereas donor unavailability accounted for only 4% of pretransplantation failures. These results suggest that survival of patients with r/r NHL entering the alloHCT route may be overestimated by a factor of 1.2-1.4 if based on actually transplanted patients only. This effect should be taken into account when using alloHCT as benchmark for new therapeutic approaches for the treatment of poor-risk NHL.
这项单中心回顾性研究的目的是通过意向性移植(ITT)评估异基因造血细胞移植(alloHCT)治疗复发/难治性(r/r)非霍奇金淋巴瘤(NHL)的疗效。纳入了2004年至2018年间所有连续进行供体搜索的弥漫性大B细胞淋巴瘤(DLBCL)、滤泡性淋巴瘤(FL)、套细胞淋巴瘤(MCL)和外周T细胞淋巴瘤(PTCL)患者。主要终点是从搜索开始时测量的总生存期(OS)。对189例患者(DLBCL 61例、FL 32例、MCL 43例和PTCL 53例)启动了供体搜索,其中76%的患者患有活动性疾病。DLBCL、FL、MCL和PTCL在搜索开始后5年的OS分别为26%、44%、52%和50%。137例患者(72%;DLBCL占64%)接受了alloHCT。未进行alloHCT的主要原因是疾病进展,而供体不可用仅占移植前失败的4%。这些结果表明,如果仅基于实际接受移植的患者,进入alloHCT途径的r/r NHL患者的生存率可能被高估1.2至1.4倍。在将alloHCT用作治疗高危NHL新治疗方法的基准时,应考虑到这种影响。