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异基因造血干细胞移植和嵌合抗原受体 T 细胞在 B 细胞非霍奇金淋巴瘤中的应用:一项两中心经验和文献复习。

Allogeneic stem cell transplantation and CAR-T in B-cell Non-Hodgkin Lymphoma: a two-center experience and review of the literature.

机构信息

Transplant and Cellular Therapy Program, Huntsman Cancer Institute, University of Utah, Utah, USA.

Cellular Therapy and Regenerative Medicine, University of Utah, Utah, USA.

出版信息

Ann Hematol. 2024 May;103(5):1717-1727. doi: 10.1007/s00277-024-05677-0. Epub 2024 Mar 2.

DOI:10.1007/s00277-024-05677-0
PMID:38429536
Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is still a potentially curative option for B-cell Non-Hodgkin Lymphoma (B-NHL) in the modern immunotherapy era. The objective of this study was to analyze long-term outcomes of patients with B-NHL who received allo-HSCT. We analyzed overall survival (OS), progression-free survival (PFS) and graft versus host disease (GVHD) relapse-free survival (GRFS) in 53 patients undergoing allo-HSCT from two institutions. The median follow-up of the study was 72 months (range 29-115 months). The median number of lines of therapy before allo-HSCT was 3 (range 1-6) and twenty-eight patients (53%) had received a previous autologous transplant. The 3-year PFS, OS and GRFS were 55%, 63%, and 55%, respectively. One-year non-relapse mortality was 26%. Karnofsky Performance Scale < 90 was associated with worse OS in multivariable analysis. A non-comparative analysis of a cohort of 44 patients with similar characteristics who received chimeric antigen receptor T-cell therapy was done, showing a 1-year PFS and OS were 60% and 66%, respectively. Our data shows that allo-HSCT is still a useful option for treating selected patients with R/R B-NHL. Our retrospective analysis and review of the literature demonstrate that allo-HSCT can provide durable remissions in a subset of patients with R/R B-NHL.

摘要

异基因造血干细胞移植(allo-HSCT)在现代免疫治疗时代仍然是 B 细胞非霍奇金淋巴瘤(B-NHL)潜在的治愈选择。本研究的目的是分析接受 allo-HSCT 的 B-NHL 患者的长期结果。我们分析了来自两个机构的 53 例接受 allo-HSCT 的患者的总生存率(OS)、无进展生存率(PFS)和移植物抗宿主病(GVHD)无复发生存率(GRFS)。研究的中位随访时间为 72 个月(范围 29-115 个月)。allo-HSCT 前的中位治疗线数为 3 条(范围 1-6),28 例(53%)接受了先前的自体移植。3 年 PFS、OS 和 GRFS 分别为 55%、63%和 55%。1 年非复发死亡率为 26%。多变量分析显示 Karnofsky 表现量表评分<90 与 OS 较差相关。对接受嵌合抗原受体 T 细胞治疗的具有相似特征的 44 例患者的队列进行了非比较分析,结果显示 1 年 PFS 和 OS 分别为 60%和 66%。我们的数据表明 allo-HSCT 仍然是治疗复发/难治性 B-NHL 患者的一种有用选择。我们的回顾性分析和文献复习表明,allo-HSCT 可以为复发/难治性 B-NHL 患者中的一部分提供持久缓解。

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本文引用的文献

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Bone Marrow Transplant. 2024 Feb;59(2):232-238. doi: 10.1038/s41409-023-02147-5. Epub 2023 Nov 25.
2
Allogeneic Stem Cell Transplantation in Mantle Cell Lymphoma; Insights into Its Potential Role in the Era of New Immunotherapeutic and Targeted Therapies: The GETH/GELTAMO Experience.套细胞淋巴瘤中的异基因干细胞移植:在新免疫治疗和靶向治疗时代对其潜在作用的见解:GETH/GELTAMO经验
Cancers (Basel). 2022 May 27;14(11):2673. doi: 10.3390/cancers14112673.
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Allogeneic stem cell transplantation in patients with mantle cell lymphoma: results from the MANTLE-FIRST study on behalf of Fondazione Italiana Linfomi.
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Leuk Lymphoma. 2021 Dec;62(14):3474-3483. doi: 10.1080/10428194.2021.1961238. Epub 2021 Oct 8.
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ASTCT, CIBMTR, and EBMT clinical practice recommendations for transplant and cellular therapies in mantle cell lymphoma.ASTCT、CIBMTR 和 EBMT 关于套细胞淋巴瘤中移植和细胞治疗的临床实践建议。
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