清髓性单倍体相合移植作为外周 T 细胞淋巴瘤的同胞相合移植的替代选择。
Myeloablative Haploidentical Transplant as an Alternative to Matched Sibling Transplant for Peripheral T-Cell Lymphomas.
机构信息
Department of Hematology, Chinese PLA General Hospital, Beijing, China.
Department of Hematology, Fujian Institute of Hematology, Fuzhou, China.
出版信息
Cell Transplant. 2021 Jan-Dec;30:963689721999615. doi: 10.1177/0963689721999615.
The number of HLA-haploidentical allogeneic hematopoietic stem-cell transplantation (Haplo-HSCT) is increasing. Comparative studies about Haplo-HSCT versus allo-HSCT with HLA-matched sibling donors (MSD-HSCT) have been tried in leukemias and B-cell lymphomas. Few studies were reported in Peripheral T-cell lymphomas (PTCLs). We performed a multicenter retrospective study about 52 patients with PTCLs undergoing Haplo-HSCT ( = 20) or MSD-HSCT ( = 32). All Haplo-HSCT recipients received antithymocyte globulin (ATG) based graft versus host disease (GVHD) prophylaxis. The median follow-up for all survivors was 38 months. The 100-day cumulative incidence of grade II to IV acute GVHD was similar (19% in the MSD-HSCT group versus 28% in the Haplo-HSCT group, 0.52). The 2-year cumulative incidence of chronic GVHD (limited and extensive) after Haplo-HSCT (30%) was also similar with that in the MSD-HSCT group (50%, 0.15). The 3-year relapse rates (33% vs 27%, 0.84) and non-relapse mortality (21% vs 22%, 0.78) did not differ between these two groups. There were also no differences in 3-year overall survival (OS) (48% vs 50%, 0.78) and progression-free survival (47% vs 51%, 0.95) between these two groups. On multivariate analysis, prognostic index for T-cell lymphoma (PIT) score (higher than 1: hazard ratio [HR], 4.0; 0.003) and disease status (stable or progression disease before HSCT: HR, 2.8; 0.03) were independent variables associated with worse OS. We concluded that ATG-based haplo-HSCT platform could work as an alternative to MSD-HSCT for patients with PTCLs.
越来越多的人选择 HLA 单倍体相合异基因造血干细胞移植（haplo-HSCT）。在白血病和 B 细胞淋巴瘤中，人们已经尝试对 haplo-HSCT 与 HLA 匹配的同胞供者 allo-HSCT（MSD-HSCT）进行比较研究。在外周 T 细胞淋巴瘤（PTCL）中，仅有少数研究报道。我们进行了一项多中心回顾性研究，纳入 52 例接受 haplo-HSCT（=20）或 MSD-HSCT（=32）的 PTCL 患者。所有 haplo-HSCT 受者均接受抗胸腺细胞球蛋白（ATG）为基础的移植物抗宿主病（GVHD）预防。所有存活患者的中位随访时间为 38 个月。MSD-HSCT 组和 haplo-HSCT 组 100 天 II 至 IV 级急性 GVHD 的累积发生率相似（分别为 19%和 28%，0.52）。haplo-HSCT 后慢性 GVHD（局限性和广泛性）的 2 年累积发生率（30%）与 MSD-HSCT 组（50%，0.15）相似。两组 3 年复发率（33% vs 27%，0.84）和非复发死亡率（21% vs 22%，0.78）无差异。两组 3 年总生存率（OS）（48% vs 50%，0.78）和无进展生存率（47% vs 51%，0.95）也无差异。多变量分析显示，T 细胞淋巴瘤预后指数（PIT）评分（高于 1：风险比[HR]，4.0；0.003）和疾病状态（HSCT 前稳定或进展：HR，2.8；0.03）是影响 OS 的独立变量。我们的结论是，基于 ATG 的 haplo-HSCT 平台可以作为 PTCL 患者的 MSD-HSCT 替代方案。
Zotero 插件