自体造血干细胞移植治疗外周T细胞淋巴瘤

摘要

BACKGROUND:The incidence rate of peripheral T cel lymphoma is high in Asia, and peripheral T cel lymphoma is aggressive with generaly poor prognosis. However, there is no standard treatment strategy. OBJECTIVE:To retrospectively analyze the therapeutic effect of autologous hematopoietic stem cel transplantation on peripheral T cel lymphoma as wel as relevant toxic and side effects. METHODS:A retrospective review was conducted in 35 patients with peripheral T cel lymphoma who underwent autologous hematopoietic stem cel transplantation from March 2003 to April 2014, including 22 cases of extranodal NK/T-cel lymphoma (nasal type), 1 case of angioimmunoblastic T-cel lymphoma, 8 cases of peripheral T cel lymphoma (non-specific), 3 cases of ALK-positive anaplastic large cel lymphoma, and 1 case of ALK-negative anaplastic large cel lymphoma. Al of 35 patients were classified pathologicaly according to WHO pathological type in 2001 and 2008, and received the high-dose chemotherapy with vincristine, cytarabine, etoposide, mitoxantrone, semustine, cyclophosphamide, and total body irradiation. RESULTS AND CONCLUSION: After a median folow-up of 54 (9-120) months, the probabilities of overal survival and disease-free survival after transplantation were 80% (n=28) and 71% (n=25), respectively. Eight cases (23%) relapsed after transplantation, seven of which died. It was safe with mild and moderate transplantation related side-effects on opportunistic infections, oral cavity mucosa and bladder responses and so on, and there were no severe, life-threatening late complications. Autologous hematopoietic stem cel transplantation may be an effective and safe treatment for peripheral T cel lymphoma, and there is a better benefit in peripheral T cel lymphoma patients with first complete remission.%背景：外周T细胞淋巴瘤亚洲地区发病率高，具有侵袭性，预后普遍较差，目前尚无标准治疗策略。目的：评价自体造血干细胞移植治疗外周T细胞淋巴瘤的疗效及毒副反应。方法：回顾性分析2003年3月至2014年4月行自体造血干细胞移植治疗外周T细胞淋巴瘤35例，包括结外NK/T细胞淋巴瘤鼻型22例，血管免疫母细胞T细胞淋巴瘤1例，外周T细胞淋巴瘤(非特殊型)8例，间变性大T细胞淋巴瘤 ALK(+)3例，ALK(-)1例；所有病例均按WHO 2001年和WHO 2008年分类进行病理分型，均采用VAEMMC+全射照射预处理方案。结果与结论：随访中位时间54个月(9-120个月)，28例患者(80%)存活，其中无病存活25例(71%)，8例(23%)复发，其中7例死亡，1例尚在治疗中。近期毒性主要为骨髓造血受抑，无明显远期并发症。结果表明自体造血干细胞移植治疗外周T细胞淋巴瘤安全有效，早期(第1次完全缓解)行移植疗效佳。