Son Espases University Hospital, IdISBa, Palma, Spain.
Hospital Sant Creu i Sant Pau, Barcelona, Spain.
Bone Marrow Transplant. 2021 Aug;56(8):1919-1928. doi: 10.1038/s41409-021-01264-3. Epub 2021 Mar 25.
We performed a retrospective multicenter study including 140 patients with relapsed/refractory (R/R) diffuse large B cell lymphoma (DLBCL) who underwent allogeneic hematopoietic stem cell transplantation (allo-SCT) from March 1995 to November 2018. Our objective was to analyze long term outcomes. Seventy-four percent had received a previous auto-SCT (ASCT) and the median number of lines pre-allo-SCT was 3 (range 1-9). Three year-event free survival (EFS) and overall survival (OS) were 38% and 44%, respectively. Non-relapse mortality (NRM) at day 100 was 19%. Cumulative incidence of grade III-IV acute graft versus host disease (GVHD) at day 100 was 16% and moderate/severe chronic GVHD at 3 years 34%. Active disease at allo-SCT (HR 1.95, p = 0.039) (HR 2.19, p = 0.019), HCT-CI ≥ 2 (2.45, p = 0.002) (HR 2.33, p = 0.006) and donor age >37 years (HR 2.75, p = 0.014) (HR 1.98, p = 0.043) were the only independent variables both for PFS and OS, respectively. NRM was significantly modified by HCT-CI ≥ 2 (HR 4.8, p = 0.008), previous ASCT (HR 4.4, p = 0.048) and grade III-IV acute GVHD on day 100 (HR 6.13, p = 0.016). Our data confirmed that allo-SCT is a curative option for patients with R/R DLBCL, displaying adequate results for fit patients with chemosensitive disease receiving an allo-SCT from a young donor.
我们进行了一项回顾性多中心研究，纳入了 140 例复发/难治性（R/R）弥漫性大 B 细胞淋巴瘤（DLBCL）患者，这些患者于 1995 年 3 月至 2018 年 11 月接受了异基因造血干细胞移植（allo-SCT）。我们的目的是分析长期结果。74%的患者接受了先前的自体-SCT（ASCT），allo-SCT 前的中位预处理线数为 3 条（范围 1-9 条）。3 年无事件生存（EFS）和总生存（OS）分别为 38%和 44%。100 天非复发死亡率（NRM）为 19%。100 天累积发生率为 III-IV 级急性移植物抗宿主病（GVHD）为 16%，3 年时中重度慢性 GVHD 为 34%。allo-SCT 时存在活动性疾病（HR 1.95，p=0.039）（HR 2.19，p=0.019），HCT-CI≥2（HR 2.45，p=0.002）（HR 2.33，p=0.006）和供者年龄>37 岁（HR 2.75，p=0.014）（HR 1.98，p=0.043）是影响 PFS 和 OS 的唯一独立变量。NRM 显著受 HCT-CI≥2（HR 4.8，p=0.008）、先前 ASCT（HR 4.4，p=0.048）和 100 天 III-IV 级急性 GVHD（HR 6.13，p=0.016）的影响。我们的数据证实，allo-SCT 是 R/R DLBCL 患者的一种治愈选择，对于接受来自年轻供者的allo-SCT、化疗敏感疾病的合适患者，可获得良好的结果。
