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淋巴细胞恶性肿瘤异基因干细胞移植的预后因素及治疗结果

Prognostic factors and treatment outcomes of allogeneic stem cell transplantation in lymphoid malignancy.

作者信息

Kim Hyungsoon, Chung Haerim, Kook Hye Won, Kim Soo-Jeong, Kim Yu Ri, Cho Hyunsoo, Cheong June-Won

机构信息

Blood Cancer Research Institute, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.

Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.

出版信息

Blood Res. 2025 Feb 10;60(1):12. doi: 10.1007/s44313-025-00060-y.

Abstract

Allogeneic stem cell transplantation (allo-SCT) is a salvage treatment option for patients with relapsed or refractory lymphoid malignancies. However, the clinical variables impacting outcomes in these patients remain unclear. We analyzed 58 patients who underwent allo-SCT for lymphoid malignancies, including B-cell lymphoma (BCL, n = 20), Hodgkin's disease (n = 3), multiple myeloma (n = 9), natural killer/T-cell lymphoma (NK/TCL, n = 4), and TCL (n = 22). The median progression-free survival (PFS) was 27.4 months, while the median overall survival (OS) was 30.6 months. In univariate analysis, human leukocyte antigen (HLA) matching and complete remission status post-transplantation were associated with improved PFS and OS. However, only post-transplant response remained significant for both survival outcomes in the multivariate analysis. Moreover, HLA matching was associated with a significantly improved PFS in patients with BCL and NK/TCL, but with better OS only in those with BCL. Complete remission after transplantation was associated with better PFS and OS in patients with BCL, NK/TCL, and TCL. Our results indicate that post-transplant response is an important prognostic indicator in allo-SCT for lymphoid malignancies and may guide clinical decisions and additional treatment.

摘要

异基因干细胞移植(allo-SCT)是复发或难治性淋巴系统恶性肿瘤患者的一种挽救性治疗选择。然而,影响这些患者预后的临床变量仍不明确。我们分析了58例接受allo-SCT治疗淋巴系统恶性肿瘤的患者,包括B细胞淋巴瘤(BCL,n = 20)、霍奇金病(n = 3)、多发性骨髓瘤(n = 9)、自然杀伤/T细胞淋巴瘤(NK/TCL,n = 4)和TCL(n = 22)。无进展生存期(PFS)的中位数为27.4个月,总生存期(OS)的中位数为30.6个月。单因素分析中,人类白细胞抗原(HLA)配型和移植后完全缓解状态与PFS和OS的改善相关。然而,多因素分析中只有移植后反应对两种生存结局仍具有显著意义。此外,HLA配型与BCL和NK/TCL患者PFS的显著改善相关,但仅与BCL患者OS的改善相关。移植后完全缓解与BCL、NK/TCL和TCL患者更好的PFS和OS相关。我们的结果表明,移植后反应是淋巴系统恶性肿瘤allo-SCT的一个重要预后指标,可能指导临床决策和进一步治疗。

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