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[C+SCAV与SEAM预处理方案在非霍奇金淋巴瘤患者自体造血干细胞移植中的疗效与安全性比较]

[A comparison of C+SCAV and SEAM conditioning regimens in efficacy and safety in autologous hematopoietic stem cell transplantation for non-Hodgkin's lymphoma patients].

作者信息

Li J Q, Zhang Y, Geng H Z, Jia S X, Wu X J, Zhou J, Zong X P, Yang Z, Chen X C, Ma C, Chen G H, Dai H P, Li C X, Wu D P

机构信息

Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Institute of Blood and Marrow Transplantation, Soochow University, Suzhou 215006, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2022 Aug 14;43(8):668-673. doi: 10.3760/cma.j.issn.0253-2727.2022.08.009.

Abstract

This study aimed to compare the efficacy and safety of cladribine, smustine, etoposide, cyclophosphamide, and cytarabine (C+SCAV) and smustine, etoposide, cytarabine, and melphalan (SEAM) conditioning regimens in autologous stem cell transplantation (auto-HSCT) for non-Hodgkin's lymphoma (NHL) . A retrospective analysis was conducted on 61 NHL patients who received auto-HSCT in the Department of Hematology, the First Affiliated Hospital of Suzhou University, from March 2018 to May 2021. The C + SCAV group and SEAM group had 19 and 42 patients, respectively. ① Among the 61 patients with NHL, 37 were male and 24 were female. The median age was 48 (21-66) years old. There were 19 cases in the C+SCAV group and 42 cases in the SEAM group. There was no significant difference in the baseline characteristics between the two groups (>0.05) . ② The median time to neutrophil and platelet engraftment in the C+SCAV cohort were 10 (8-15) days and 13 (9-22) days, respectively, which does not differ from the SEAM group (=0.103, =0.403) . ③ No differences existed between the two groups in terms of survival. The 1-year progression-free survival (PFS) was (76.5±10.3) % for patients receiving C+SCAV and (78.4±6.8) % for those who received SEAM (=0.841) . The 1-year overall survival was 100.0% for the C+SCAV group and 95.2±3.3% for the SEAM group (=0.339) . ④The 1-year PFS of patients with complete remission in the C+SCAV group was similar to those who in the SEAM group [ (92.3±7.4) % (82.5±7.2) %, =0.406]. ⑤ The incidence of non-hematological serious adverse events (≥ grade 3) in the C+SCAV group and SEAM group were 10.5% (2/19) and 40.5% (17/42) (=0.013) , the incidence of severe mucositis was 5.3% (1/19) and 31.0% (13/42) (=0.015) , and the incidence of severe infection (≥ grade 3) was 10.5% (2/19) and 19.0% (8/42) (=0.389) , respectively. C + SCAV conditioning regimen appeared to be no different from the SEAM regimen in terms of survival. It can lower the incidence of SAE and does not increase the risk of severe infection. As a result, it can be used as an alternative conditioning regimen for lymphoma patients undergoing auto-HSCT.

摘要

本研究旨在比较克拉屈滨、司莫司汀、依托泊苷、环磷酰胺和阿糖胞苷(C+SCAV)与司莫司汀、依托泊苷、阿糖胞苷和美法仑(SEAM)预处理方案在非霍奇金淋巴瘤(NHL)自体干细胞移植(auto-HSCT)中的疗效和安全性。对2018年3月至2021年5月在苏州大学第一附属医院血液科接受auto-HSCT的61例NHL患者进行回顾性分析。C + SCAV组和SEAM组分别有19例和42例患者。①61例NHL患者中,男性37例,女性24例。中位年龄为48(21-66)岁。C+SCAV组19例,SEAM组42例。两组基线特征无显著差异(>0.05)。②C+SCAV队列中中性粒细胞和血小板植入的中位时间分别为10(8-15)天和13(9-22)天,与SEAM组无差异(=0.103,=0.403)。③两组在生存方面无差异。接受C+SCAV的患者1年无进展生存期(PFS)为(76.5±10.3)%,接受SEAM的患者为(78.4±6.8)%(=0.841)。C+SCAV组1年总生存率为100.0%,SEAM组为95.2±3.3%(=0.339)。④C+SCAV组完全缓解患者的1年PFS与SEAM组相似[(92.3±7.4)% (82.5±7.2)%,=0.406]。⑤C+SCAV组和SEAM组非血液学严重不良事件(≥3级)的发生率分别为10.5%(2/19)和40.5%(17/42)(=0.013),严重黏膜炎的发生率分别为5.3%(1/19)和31.0%(13/42)(=0.015),严重感染(≥3级)的发生率分别为10.5%(2/19)和19.0%(8/42)(=0.389)。C + SCAV预处理方案在生存方面似乎与SEAM方案无差异。它可以降低严重不良事件的发生率,且不增加严重感染的风险。因此,它可以作为接受auto-HSCT的淋巴瘤患者的替代预处理方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcae/9593007/e12c67515522/cjh-43-08-668-g001.jpg

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