Kröger Kai, Siats Jan, Kerkhoff Andrea, Lenz Georg, Stelljes Matthias, Eich Hans Theodor, Reinartz Gabriele
Department of Radiation Oncology, University Hospital of Muenster, Albert-Schweitzer Campus 1, Building 1A, 48419 Muenster, Germany.
Bone Marrow Transplantation Unit, Department of Hematology and Oncology, University Hospital of Muenster, Albert-Schweitzer Campus 1, Building 1A, 48419 Muenster, Germany.
Cancers (Basel). 2023 Feb 3;15(3):983. doi: 10.3390/cancers15030983.
In patients with mantle cell lymphoma (MCL), long-term remissions can be achieved by stem cell transplantation (SCT). Different conditioning treatment protocols exist with or without total body irradiation (TBI). There are few data published on the role of TBI before autologous stem cell transplantation (autoSCT) or allogenic stem cell transplantation (alloSCT). We report on the long-term survival data of patients treated by TBI prior to autologous or allogenic SCT at our center.
In a retrospective analysis, the data of patients treated at the University Hospital of Muenster from May 2004 to February 2015 were collected and evaluated. For the analysis, all data of patients who were histopathologically diagnosed with MCL and underwent TBI prior to stem cell transplantation (SCT) were evaluated.
A total of 22 patients (19 men and 3 women) were treated with a TBI-based conditioning prior to SCT. The median age at initial diagnosis was 57.5 years (38-65 years). Seventeen patients had Ann Arbor stage IV, two patients had Ann Arbor stage III, and three patients Ann Arbor stage II disease. AutoSCT was performed in 19 patients and alloSCT was performed in 3 patients. In 18 patients, autoSCT was applied as part of first-line therapy, and in one patient after relapse. Two patients received alloSCT after relapse of MCL, and one patient received alloSCT during first-line therapy after an inadequate treatment response. TBI was performed in 12 patients with 10 Gy and in 6 patients with 12 Gy, these patients subsequently received autoSCT. In the group of four patients who received TBI with four Gy, four patients subsequently received alloSCT and one patient received autoSCT. Median overall survival after autoSCT and previous TBI was 11.4 years (142 months). In total, 11 out of 19 patients treated with autoSCT lived longer than 6.8 years (82-202 months). After alloSCT and previous TBI, the median overall survival was 3.25 years (14-59 months).
A large proportion of patients with advanced MCL survived remarkably longer than 11.4 years after high-dose chemotherapy, TBI, and SCT. The present results of multimodal treatment support the published reports that TBI-based high-dose therapy followed by autoSCT is highly effective in this prognostically unfavorable disease situation.
在套细胞淋巴瘤（MCL）患者中，干细胞移植（SCT）可实现长期缓解。存在不同的预处理治疗方案，有或没有全身照射（TBI）。关于自体干细胞移植（autoSCT）或异基因干细胞移植（alloSCT）前TBI的作用，发表的数据很少。我们报告了在我们中心接受自体或异基因SCT前接受TBI治疗的患者的长期生存数据。
在一项回顾性分析中，收集并评估了2004年5月至日2015年2月在明斯特大学医院接受治疗的患者的数据。为进行分析，对所有经组织病理学诊断为MCL且在干细胞移植（SCT）前接受TBI的患者的数据进行了评估。
共有22例患者（19例男性和3例女性）在SCT前接受了基于TBI的预处理。初次诊断时的中位年龄为57.5岁（38 - 65岁）。17例患者为Ann Arbor分期IV期，2例患者为Ann Arbor分期III期，3例患者为Ann Arbor分期II期疾病。19例患者接受了autoSCT，3例患者接受了alloSCT。18例患者中，autoSCT作为一线治疗的一部分应用，1例患者在复发后应用。2例患者在MCL复发后接受了alloSCT，1例患者在一线治疗后治疗反应不佳时接受了alloSCT。12例患者接受了10 Gy的TBI，6例患者接受了12 Gy的TBI，这些患者随后接受了autoSCT。在接受4 Gy TBI的4例患者组中，4例患者随后接受了alloSCT，1例患者接受了autoSCT。autoSCT及先前TBI后的中位总生存期为11.4年（142个月）。总共，19例接受autoSCT治疗的患者中有11例存活超过6.8年（82 - 202个月）。alloSCT及先前TBI后，中位总生存期为3.25年（14 - 59个月）。
很大一部分晚期MCL患者在接受大剂量化疗、TBI和SCT后存活时间显著超过11.4年。目前多模式治疗的结果支持已发表的报告，即基于TBI的大剂量治疗随后进行autoSCT在这种预后不良的疾病情况下非常有效。
