造血干细胞移植治疗间变大细胞淋巴瘤的临床分析
目的:探讨造血干细胞移植治疗间变大细胞淋巴瘤（ALCL）的疗效及预后。方法:回顾性分析全国八家三甲医院2005年1月至2017年12月收治的33例接受造血干细胞移植（HSCT）的ALCL患者临床资料，评价自体造血干细胞移植（auto-HSCT）和异基因造血干细胞移植（allo-HSCT）治疗ALCL的生存率、复发率和影响预后的相关因素。结果:33例接受HSCT的ALCL患者的中位发病年龄为31（12~57）岁，男23例，女10例，间变性淋巴瘤激酶阳性（ALK +）和阴性（ALK -）分别为24例（72.7%）和9例（27.3%）。25例患者接受auto-HSCT（ALK +患者19例，ALK...
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| Published in | 中华血液学杂志 Vol. 41; no. 2; pp. 117 - 122 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | Chinese |
| Published |
解放军总医院血液科，北京 100853%福建医学大学附属协和医院血液科，福州 350001%北京大学附属第一医院血液科 100034%首都医科大学附属北京友谊医院血液科 100050%郑州大学第一附属医院肿瘤科 450000%解放军原304医院血液科，北京 100037%解放军原307医院造血干细胞移植中心，北京 100071%陆军军医大学新桥医院血液科，重庆 400037
01.02.2020
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0253-2727 |
| DOI | 10.3760/cma.j.issn.0253-2727.2020.02.006 |
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| Abstract | 目的:探讨造血干细胞移植治疗间变大细胞淋巴瘤（ALCL）的疗效及预后。方法:回顾性分析全国八家三甲医院2005年1月至2017年12月收治的33例接受造血干细胞移植（HSCT）的ALCL患者临床资料，评价自体造血干细胞移植（auto-HSCT）和异基因造血干细胞移植（allo-HSCT）治疗ALCL的生存率、复发率和影响预后的相关因素。结果:33例接受HSCT的ALCL患者的中位发病年龄为31（12~57）岁，男23例，女10例，间变性淋巴瘤激酶阳性（ALK
+）和阴性（ALK
-）分别为24例（72.7%）和9例（27.3%）。25例患者接受auto-HSCT（ALK
+患者19例，ALK
-患者6例），8例患者接受allo-HSCT（ALK
+患者5例，ALK
-患者3例）。移植后中位随访时间18.7（4.0~150.0）个月。移植前疾病缓解状态：完全缓解6例（均行auto-HSCT），部分缓解16例（auto-HSCT组14例，allo-HSCT组2例），复发难治11例（auto-HSCT组5例，allo-HSCT组6例）。疾病进展死亡7例，其中auto-HSCT组5例（20.0%），allo-HSCT组2例（25.0%）。移植相关死亡（TRM）5例，其中auto-HSCT组2例（8.0%），allo-HSCT组3例（37.5%）。auto-HSCT后中位无进展生存（PFS）和总生存（OS）时间均为15个月，allo-HSCT后中位PFS时间为3.7（1.0~90.0）个月，中位OS时间为4.6（1.0~90.0）个月，两组生存曲线差异无统计学意义（OS及PFS
P值分别为0.247和0.317）。auto-HSCT和allo-HSCT组的2年OS率分别为72%和50%，5年OS率分别为36%和25%。
结论:ALCL化疗反应率高，有不良预后因素的情况下化疗后序贯auto-HSCT为重要治疗措施，高危患者或可从allo-HSCT中获益。 |
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| AbstractList | 目的:探讨造血干细胞移植治疗间变大细胞淋巴瘤（ALCL）的疗效及预后。方法:回顾性分析全国八家三甲医院2005年1月至2017年12月收治的33例接受造血干细胞移植（HSCT）的ALCL患者临床资料，评价自体造血干细胞移植（auto-HSCT）和异基因造血干细胞移植（allo-HSCT）治疗ALCL的生存率、复发率和影响预后的相关因素。结果:33例接受HSCT的ALCL患者的中位发病年龄为31（12~57）岁，男23例，女10例，间变性淋巴瘤激酶阳性（ALK
+）和阴性（ALK
-）分别为24例（72.7%）和9例（27.3%）。25例患者接受auto-HSCT（ALK
+患者19例，ALK
-患者6例），8例患者接受allo-HSCT（ALK
+患者5例，ALK
-患者3例）。移植后中位随访时间18.7（4.0~150.0）个月。移植前疾病缓解状态：完全缓解6例（均行auto-HSCT），部分缓解16例（auto-HSCT组14例，allo-HSCT组2例），复发难治11例（auto-HSCT组5例，allo-HSCT组6例）。疾病进展死亡7例，其中auto-HSCT组5例（20.0%），allo-HSCT组2例（25.0%）。移植相关死亡（TRM）5例，其中auto-HSCT组2例（8.0%），allo-HSCT组3例（37.5%）。auto-HSCT后中位无进展生存（PFS）和总生存（OS）时间均为15个月，allo-HSCT后中位PFS时间为3.7（1.0~90.0）个月，中位OS时间为4.6（1.0~90.0）个月，两组生存曲线差异无统计学意义（OS及PFS
P值分别为0.247和0.317）。auto-HSCT和allo-HSCT组的2年OS率分别为72%和50%，5年OS率分别为36%和25%。
结论:ALCL化疗反应率高，有不良预后因素的情况下化疗后序贯auto-HSCT为重要治疗措施，高危患者或可从allo-HSCT中获益。 |
| Abstract_FL | Objective:To explore the efficacy and prognostic factors of hematopoietic stem cell transplantation (HSCT) for the treatment of patients with anaplastic large cell lymphoma (ALCL) .Methods:The clinical records of 33 ALCL patients after HSCT were collected and analyzed retrospectively to evaluate the rates of overall survival (OS) and recurrence after autologous (auto-HSCT) and allogeneic HSCT (allo-HSCT) and the factors influencing prognosis.Results:The median-age of this cohort of 33 ALCL cases at diagnosis was 31 (12-57) years old with a male/female ratio of 23/10, 24 cases (72.7%) were ALK
+ and 9 ones (27.3%) ALK
-. Of them, 25 patients (19 ALK
+ and 6 ALK
-) underwent auto-HSCT and 8 cases (5 ALK
+ and 3ALK
-) allo-HSCT with a median follow-up of 18.7 (4.0-150.0) months. Disease states before HSCT were as follows: only 6 patients achieved CR status and received auto-HSCT, 16 patients achieved PR (14 cases by auto-HSCT and 2 ones allo-HSCT) , the rest 11 cases were refractory/relapse (5 cases by auto-HSCT and 6 ones allo-HSCT) . There were 7 cases died of disease progression (5 after auto-HSCT and 2 allo-HSCT) and 5 cases treatment-related mortality (TRM) (2 after auto-HSCT and 3 allo-HSCT) , TRM of two groups were 8.0% and 37.5%, respectively. Both the median progression-free survival (PFS) and OS were 15 months after auto-HSCT, the median PFS and OS after allo-HSCT were 3.7 (1.0-90.0) and 4.6 (1.0-90.0) months, respectively. There was no statistically significant difference in terms of survival curves between the two groups (OS and PFS,
P=0.247 and
P=0.317) . The 2-year OS rates in auto-HSCT and allo-HSCT groups were 72% and 50%, respectively. The 5-year OS rates in auto-HSCT and allo-HSCT groups were 36% and 25%, respectively.
Conclusion:ALCL treated by chemotherapy produced high rates of overall and complete responses. Chemotherapy followed by auto-HSCT remained to be good choice for patients with poor prognostic factors. High-risk patients should be considered more beneficial from allo-HSCT. |
| Author | 黄文荣 刘耀 王买红 董玉君 李乃农 王昭 吴晓雄 李晓帆 胡亮钉 卢柠 吴亚妹 任汉云 付晓瑞 李欲航 王旖旎 张明智 |
| AuthorAffiliation | 解放军总医院血液科，北京 100853%福建医学大学附属协和医院血液科，福州 350001%北京大学附属第一医院血液科 100034%首都医科大学附属北京友谊医院血液科 100050%郑州大学第一附属医院肿瘤科 450000%解放军原304医院血液科，北京 100037%解放军原307医院造血干细胞移植中心，北京 100071%陆军军医大学新桥医院血液科，重庆 400037 |
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| Author_FL | Li Nainong Dong Yujun Lu Ning Li Yuhang Wang Zhao Wu Yamei Huang Wenrong Hu Liangding Fu Xiaorui Li Xiaofan Wu Xiaoxiong Ren Hanyun Liu Yao Wang Yini Zhang Mingzhi Wang Maihong |
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| Author_xml | – sequence: 1 fullname: 卢柠 – sequence: 2 fullname: 李晓帆 – sequence: 3 fullname: 董玉君 – sequence: 4 fullname: 王旖旎 – sequence: 5 fullname: 付晓瑞 – sequence: 6 fullname: 吴亚妹 – sequence: 7 fullname: 李欲航 – sequence: 8 fullname: 王买红 – sequence: 9 fullname: 李乃农 – sequence: 10 fullname: 任汉云 – sequence: 11 fullname: 王昭 – sequence: 12 fullname: 张明智 – sequence: 13 fullname: 吴晓雄 – sequence: 14 fullname: 胡亮钉 – sequence: 15 fullname: 刘耀 – sequence: 16 fullname: 黄文荣 |
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| Keywords | Prognosis 间变大细胞淋巴瘤 Anaplastic large cell lymphoma Clinical analysis 预后 临床分析 造血干细胞移植 Hematopoietic stem cell transplantation |
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| Title | 造血干细胞移植治疗间变大细胞淋巴瘤的临床分析 |
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