IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.
Dipartimento di Medicina Specialistica e Sperimentale, Università di Bologna, Bologna, Italy.
Curr Hematol Malig Rep. 2021 Feb;16(1):82-88. doi: 10.1007/s11899-021-00609-5. Epub 2021 Mar 1.
The treatment landscape of mantle cell (MCL) and peripheral T-cell lymphomas (PTCL) is rapidly changing; however, despite improvement in patients' survival, they still remain a largely incurable diseases. Treatment choice is dependent on patient factors, prior therapy, remission duration, and candidacy for stem cell transplantation (SCT). There are subsets of high-risk patients who do not benefit substantially from autologous SCT (ASCT) and for whom alternative targeted approaches are being examined. Here, we critically analyze the actual role of ASCT in PTCL and MCL.
Research in areas of maintenance therapy and minimal residual disease is ongoing to identify MCL patients who may not require ASCT for durable response. Moreover, there are subsets of high-risk MCL patients who do not benefit substantially from ASCT and for whom alternative, targeted approaches are being examined. Much less clear evidence exists regarding the impact of consolidative ASCT in PTCL, mainly for the heterogeneity of these lymphomas: it is still controversial whether patients who achieved a complete response significantly take advantage of this procedure over active surveillance only. Several clinical and biologic markers are available to predict prognosis; however, despite improvements in outcomes, standard therapeutic approaches have not been able to overcome high-risk disease features for PTCL and MCL. Thus, the need of ASCT for these diseases is still matter of debate among hematologists.
套细胞淋巴瘤（MCL）和外周 T 细胞淋巴瘤（PTCL）的治疗领域正在迅速变化；然而，尽管患者的生存率有所提高，但这些疾病仍然基本上无法治愈。治疗选择取决于患者因素、既往治疗、缓解持续时间和干细胞移植（SCT）的资格。有一些高危患者亚组从自体 SCT（ASCT）中获益不大，正在研究替代的靶向方法。在这里，我们批判性地分析了 ASCT 在 PTCL 和 MCL 中的实际作用。
维持治疗和微小残留病的研究正在进行中，以确定可能不需要 ASCT 即可获得持久反应的 MCL 患者。此外，还有一些高危 MCL 患者从 ASCT 中获益不大，正在研究替代的靶向方法。关于巩固性 ASCT 在 PTCL 中的影响的证据较少，主要是因为这些淋巴瘤的异质性：对于完全缓解的患者，与仅主动监测相比，是否显著受益于该程序仍存在争议。有多种临床和生物学标志物可用于预测预后；然而，尽管结局有所改善，但标准治疗方法仍未能克服 PTCL 和 MCL 的高危疾病特征。因此，ASCT 对这些疾病的需求仍然是血液病学家之间争论的问题。
