侵袭性T细胞性非霍奇金淋巴瘤自体造血干细胞移植后长期随访结果  

Long Term Outcome of Autologous Hematopoietic Stem Cell Transplantation (AHSCT) for Aggressive T-Cell Non-Hodgkin’s Lymphoma

作　　者：卜庆[1] 黄慧强[1] 林旭滨[1] 蔡清清[1] 高岩[1] 王潇潇[1] 周颖[1] 

机构地区：[1]中山大学肿瘤防治中心//国家华南肿瘤学重点实验室,广东广州510060

出　　处：《中山大学学报（医学科学版）》2009年第3期352-356,共5页Journal of Sun Yat-Sen University:Medical Sciences

摘　　要：【目的】评价自体造血干细胞移植(AHSCT)治疗侵袭性T细胞性非霍奇金淋巴瘤(T-NHL)的临床疗效及安全性。【方法】本文回顾性分析1994～2008年间,我院收治的AHSCT治疗后长期随访的侵袭性T-NHL36例,初治11例(30.6%),复发11例(30.6%)和难治性病例14例(38.9%)。病理类型包括T淋巴母细胞淋巴瘤16例(44.4%)、间变大细胞性淋巴瘤8例(22.2%)和外周T非特异型淋巴瘤5例(13.9%)。【结果】35例患者可评价疗效。中位无进展生存时间(PFS)38.7个月,预计1年、3年和5年无进展生存率分别为56%,46%和46%。预计中位总生存时间54月,1年、3年和5年总生存率分别为69%,58%,49%。移植后17例(48.6%)患者复发,4例患者仍带瘤生存。移植前为难治性病例和骨髓侵犯是本组患者不良预后相关的因素。主要Ⅲ～Ⅳ度不良反应为发热、口腔溃疡;1例治疗相关死亡。【结论】AHSCT常规化疗后治疗T细胞淋巴瘤安全有效,但复发率仍偏高,值得开展大规模的临床试验进一步深入研究。[Objective] This study was designed to evaluate the clinical efficacy and safety of AHSCT for the aggressive T cell non-Hodgkin lymphoma （T-NHL）. [Methods] We reported and analyzed 36 patients with aggressive T-NHL in our Hospital from 1994 to 2008 retrospectively. These were 11 （30.6%） patients untreated, 11 （30.6%） relapsed and 14 （38.9%） refractory. The major pathological subtype were lymphoblastic lymphoma 16 （44.4%） cases, anaplastic large cell 8 （22.2%） cases and peripheral T-cell 5 （13.9%） cases. Patients had received median 4 regimens and median 9 cycles administered before AHSCT. [Result] After median follow-up time of 23 （8-132） months. Thirty-five patients were eligible among 36 patients enrolled and 1 patient lost follow-up. Median progressive free survival （PFS） was 38.7 months for whole group. The actual probability of 1, 3, and 5-year PFS rates were 56%, 46%, and 46%, respectively. The median overall survival （OS） was 54 months. 1, 3, and 5- year OS were 69%, 58%, and 49% respectively. Total 17 （48.6%） patients were relapsed and 4 of them remained alive. The poor prognostic factor was refractory characteristic and bone marrow involved. The main toxicities were febrile neutropenia and mucositis. [ Conclusion ] This administered AHSCT after response to conventional chemotherapy effective and safe for relapsed or refractory patients with T cell NHL though the recurrent rate remained relative high. Further randomized clinical trial is urgently warranted.

关 键 词：淋巴瘤 自体造血干细胞移植 淋巴母细胞性淋巴瘤 

分 类 号：R733.4[医药卫生—肿瘤]