Nottingham University Hospitals NHS Trust, Nottingham, UK.
Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham, UK.
Br J Haematol. 2022 Feb;196(4):932-938. doi: 10.1111/bjh.17896. Epub 2021 Oct 18.
Systemic anaplastic large-cell lymphoma (sALCL) is a rare T-cell lymphoma associated with poor prognosis after relapse. The immunoconjugate brentuximab vedotin (BV) first became available for relapsed sALCL in England in 2013, following the results of a pivotal phase II study. We present a population-based study describing outcomes of relapsed sALCL in England after BV, using Public Health England data. We obtained information on all relapsed/refractory (r/r) sALCL patients ≥18 years treated with BV monotherapy in England between 1 January 2014 and 31 December 2019. The final cohort comprised 127 patients with a median age of 60 years (range 19-89). Eighteen (14·2%) had received stem cell transplant in first remission. Median two-year overall survival (OS) was 46·6%. The vast majority of deaths (59) occurred within 18 months, with very few events after this. Receipt of BV as second line compared to third or fourth line was associated with significantly improved survival (two-year OS 50·3% vs 29·7%, P = 0·03). There was no difference in OS for different subgroups, including anaplastic lymphoma kinase status, age, gender, or receipt of stem cell transplantation in first response. We report excellent survival following treatment with BV in a real-world setting, comparable with previous clinical trial data.
系统性间变性大细胞淋巴瘤(sALCL)是一种罕见的 T 细胞淋巴瘤,在复发后预后较差。免疫偶联药物 Brentuximab vedotin(BV)于 2013 年在英国首次用于复发的 sALCL,此前进行了一项关键的 II 期研究。我们使用英国公共卫生署的数据,进行了一项基于人群的研究,描述了英国在使用 BV 后复发 sALCL 的结果。我们获得了 2014 年 1 月 1 日至 2019 年 12 月 31 日期间在英国接受 BV 单药治疗的所有年龄≥18 岁的复发/难治性(r/r)sALCL 患者的信息。最终队列包括 127 名中位年龄为 60 岁(19-89 岁)的患者。18 名(14.2%)患者在首次缓解期接受了干细胞移植。中位 2 年总生存期(OS)为 46.6%。绝大多数死亡(59 例)发生在 18 个月内,此后很少有事件发生。与三线或四线治疗相比,二线接受 BV 治疗与生存显著改善相关(2 年 OS 为 50.3%比 29.7%,P=0.03)。不同亚组之间的 OS 没有差异,包括间变性淋巴瘤激酶状态、年龄、性别或在首次反应中接受干细胞移植。我们报告了在真实环境中使用 BV 治疗后的极好的生存结果,与之前的临床试验数据相当。