Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Eur J Haematol. 2024 Feb;112(2):276-285. doi: 10.1111/ejh.14113. Epub 2023 Oct 16.
Allogeneic stem cell transplantation (allo-SCT) may have a curative potential due to the graft versus lymphoma effect. In this study, we aimed to compare transplant outcomes between refractory-T-NHL (ref-NHL) and Chemosensitive-T-NHL (CS-T-NHL).
We retrospectively reviewed the records of 26 ref-NHL and 29 CS-T-NHL consecutive patients who underwent allo-SCT at our center and compared the transplant outcomes between the groups.
All patients were heavily pretreated with 27% of patients relapsing post-auto-SCT and two patients in the ref-T-NHL post-allo-SCT. Patients were transplanted mainly from unrelated donors. There were no differences in leucocytes and platelet engraftment between the two groups. At 3 years, the relapse incidence was 34% in Ref-TNHL and 19% in CS-TNHL (p = .33), with non-relapse mortality rates of 28% and 22%, respectively (p = .52). Female patients and those with a previous auto-SCT had lower relapse incidence (p = .045, p = .003). The 3-year overall survival was 39% in Ref-TNHL and 56% in CS-TNHL (p = .15). Trends for improved progression-free survival (PFS) and graft-versus-host disease relapse-free survival (GRFS) were observed in the CS-TNHL group (PFS: 60% vs. 30%, p = .075; GRFS: 38% vs. 21%, p = .1).
Acknowledging the retrospective nature of our study, our results indicate that allo-SCT has a curative potential in patients with T-NHL even in refractory status.
异基因干细胞移植(allo-SCT)可能具有治愈潜力,因为移植物抗淋巴瘤效应。本研究旨在比较难治性 T-NHL(ref-NHL)和化疗敏感 T-NHL(CS-T-NHL)患者的移植结果。
我们回顾性分析了在我们中心接受 allo-SCT 的 26 例 ref-NHL 和 29 例 CS-T-NHL 连续患者的记录,并比较了两组患者的移植结果。
所有患者均经过大量预处理,其中 27%的患者在自体外周血干细胞移植后复发,2 例在 ref-T-NHL 患者在 allo-SCT 后复发。患者主要接受无关供者移植。两组白细胞和血小板植入无差异。3 年时,ref-TNHL 组的复发率为 34%,CS-TNHL 组为 19%(p=0.33),非复发死亡率分别为 28%和 22%(p=0.52)。女性患者和有既往自体外周血干细胞移植史的患者复发率较低(p=0.045,p=0.003)。ref-TNHL 组 3 年总生存率为 39%,CS-TNHL 组为 56%(p=0.15)。CS-TNHL 组无进展生存(PFS)和移植物抗宿主病无复发生存(GRFS)的趋势有所改善(PFS:60%比 30%,p=0.075;GRFS:38%比 21%,p=0.1)。
鉴于本研究的回顾性,我们的结果表明,allo-SCT 对 T-NHL 患者具有治愈潜力,即使在难治性状态下也是如此。