自体造血干细胞移植治疗T淋巴母细胞淋巴瘤41例临床研究  

Autologous hematopoietic stem cell transplantation treatment for T cell lymphoblastic lymphoma

作　　者：王普 李彩霞[1] 张莹[1] 陈佳[1] 陈晓晨[1] 杨丹 周进[1] 宗香萍 杨贞[1] 吴梦[2] 杨明子 宋玉琴[2] 朱军[2] 吴德沛[1] Wang Pu;Li Caixia;Zhang Ying;Chen Jia;Chen Xiaochen;Yang Dan;Zhou Jin;Zong Xiangping;Yang Zhen;Wu Meng;Yang Mingzi;Song Yuqin;Zhu Jun;Wu Depei(Department of Hematology,The First Affiliiliated Hospital of Soochow University,Jiangsu Insititute of Hematology,Suzhou 215006,China;Department of Lymphoma,Key laboratory of Carcinogenesis and Translational Research(Ministry of Education),Peking University Cancer Hospital&Institute,Beijing 100142,China)

机构地区：[1]苏州大学附属第一医院血液科,江苏省血液研究所,国家血液系统疾病临床医学研究中心,血液学协同创新中心,215006 [2]北京大学肿瘤医院,北京市肿瘤防治研究所淋巴肿瘤内科,恶性肿瘤发病机制及转化研究教育部重点实验室,100142

出　　处：《中华血液学杂志》2020年第3期198-203,共6页Chinese Journal of Hematology

基　　金：苏州市科技发展计划(SYS2018049)。

摘　　要：目的探讨自体造血干细胞移植(auto-HSCT)巩固治疗T淋巴母细胞淋巴瘤(T-LBL)的疗效及相关影响因素。方法对2006年4月至2017年7月在苏州大学附属第一医院血液科和北京大学肿瘤医院淋巴瘤科接受auto-HSCT的41例T-LBL患者进行回顾性分析。结果①41例T-LBL患者中,男30例,女11例,中位年龄24(11~53)岁,12例(29.3%)纵隔累及,20例(48.8%)骨髓累及,Ann Arbor分期Ⅲ期及以上33例(80.5%);移植前疾病处于第1次完全缓解(CR1)期26例(63.4%),非CR1期15例(36.6%);移植前国际预后指数(IPI)中低危组(<3分)29例(70.7%),中高危组(≥3分)12例(29.3%)。②移植后中位随访29(3~98)个月,全部41例患者的3年总生存(OS)率、无进展生存(PFS)率分别为(64.3±8.2)%、(66.0±7.8)%,3年累积复发率(CIR)为(30.7±7.4)%,3年非复发死亡率(NRM)为(4.8±4.6)%。③CR1组、非CR1组患者3年OS率分别为(83.4±7.6)%、(38.9±12.9)%(P=0.010),3年PFS率分别为(83.8±7.4)%、(40.0±12.6)%(P=0.006),3年CIR分别为(16.2±7.4)%、(53.3±12.9)%(P=0.015),3年NRM分别为0、(14.3±13.2)%(P=0.157)。④IPI中低危组、中高危组3年OS率分别为(76.9±8.4)%、(35.7±15.2)%(P=0.014),3年PFS率分别为(77.4±8.2)%、(40.0±14.6)%(P=0.011),3年CIR分别为(18.1±7.3)%、(60.0±14.6)%(P=0.006),3年NRM分别为(5.6±5.4)%、0(P=0.683)。结论auto-HSCT可显著改善T-LBL患者的预后,移植前疾病状态和IPI评分是影响auto-HSCT疗效的重要因素。Objective To investigate the efficacy and predictors of autologous hematopoietic stem cell transplantation(auto-HSCT)in the treatment of T lymphoblastic lymphoma(T-LBL).Methods 41 patients with T-LBL who underwent auto-HSCT from April 2006 to July 2017 in the Department of Hematology,the First Affiliated Hospital of Soochow University and the Department of Lymphoma,Peking University Cancer Hospital were analyzed retrospectively.Results①Among 41 patients,there were 30 males and 11 females with median age of 24(11-53)years old.According to the Ann Arbor staging,33(80.5%)patients were in stageⅢ/Ⅳ.12(29.3%)patients have mediastinal involvement,and 20(48.8%)patients have bone marrow(BM)involvement.Before transplantation,there were 26(63.4%)patients who achieved first complete remission(CR1),the other 15(36.6%)patients were in the non-CR1 group,and there were 29(70.7%)patients in the low-intermediate risk group(IPI<3 scores),the other 12(34.1%)patients were in the middle-high risk group(IPI≥3 scores).②The median follow-up was 29(3-98)months.The 3-year overall survival(OS)and progression-free survival(PFS)for 41 patients were(64.3±8.2)%and(66.0±7.8)%,respectively.3-year cumulative recurrence rate(CIR)was(30.7±7.4)%,and 3-year non-recurring mortality(NRM)was(4.8±4.6)%.③The 3-year OS of the CR1 group and the non-CR1 group were(83.4±7.6)%and(38.9±12.9)%(P=0.010),and the 3-year PFS of two groups were(83.8±7.4)%and(40.0±12.6)%(P=0.006),respectively.The 3-year CIR of these two groups were(16.2±7.4)%and(53.3±12.9)%(P=0.015),and the 3-year NRM were 0 and(14.3±13.2)%(P=0.157),respectively.④The 3-year OS of the IPI low-intermediate risk group and the high-intermediate risk group were(76.9±8.4)%and(35.7±15.2)%(P=0.014)and the 3-year PFS were(77.4±8.2)%and(40.0±14.6)(P=0.011),respectively.The 3-year CIR of these two groups were(18.1±7.3)%and(60.0±14.6)%(P=0.006),and the 3-year NRM were(5.6±5.4)%and 0(P=0.683),respectively.The OS and PFS of patients with low-intermediate risk group were significantly

关 键 词：T淋巴母细胞淋巴瘤 自体造血干细胞移植 疗效 影响因素 

分 类 号：R733[医药卫生—肿瘤]