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异基因干细胞移植可使套细胞淋巴瘤获得长期缓解,包括在突变疾病中。

Allogeneic stem cell transplantation achieves long-term remissions in mantle cell lymphoma, including in -mutated disease.

机构信息

Department of Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Australia.

Blood Cells and Blood Cancer Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia.

出版信息

Leuk Lymphoma. 2023 Nov-Dec;64(11):1792-1800. doi: 10.1080/10428194.2023.2241095. Epub 2023 Aug 2.

Abstract

Cytarabine-containing chemoimmunotherapy followed by autologous transplantation and rituximab maintenance achieves durable remissions for most patients with mantle cell lymphoma (MCL). However, patients with -mutated disease have poor outcomes with standard approaches. We previously reported that allogeneic stem cell transplantation (alloSCT) achieved durable remissions in MCL, however follow-up among patients with -mutated disease was limited. Here we report extended follow-up of the overall cohort ( 36) and mutated subset  13) (median follow-up 10.8 and 4.2 years, respectively). Estimated overall survival was 56% at 10 years for the overall cohort and 59% at 4 years for the mutated subset. Among patients with mutated disease, no relapses occurred beyond 6 months post-transplant. Survival after post-alloSCT disease relapse was poor (median 2.1 years). These data confirm that alloSCT can be curative in MCL, including patients with -mutated disease, and should be considered for earlier utilization in this subgroup for whom conventional chemoimmunotherapy is ineffective.

摘要

含有阿糖胞苷的化疗免疫治疗后进行自体移植和利妥昔单抗维持治疗,可使大多数套细胞淋巴瘤(MCL)患者获得持久缓解。然而,标准治疗方法对 -突变疾病患者的疗效较差。我们之前报道过异基因造血干细胞移植(alloSCT)可使 MCL 患者获得持久缓解,但 -突变疾病患者的随访有限。在这里,我们报告了对整个队列( 36 例)和突变亚组( 13 例)的扩展随访(中位随访时间分别为 10.8 年和 4.2 年)。对于整个队列,10 年的总生存率为 56%,对于突变亚组,4 年的总生存率为 59%。在 -突变疾病患者中,移植后 6 个月以上未发生复发。alloSCT 后疾病复发后的生存情况较差(中位 2.1 年)。这些数据证实,alloSCT 可治愈 MCL,包括 -突变疾病患者,对于那些常规化疗免疫治疗无效的患者,应考虑更早地应用这种方法。

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