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首页> 外文期刊>Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation >T Cell-Replete Haploidentical Transplantation with Post-Transplantation Cyclophosphamide for Hodgkin Lymphoma Relapsed after Autologous Transplantation: Reduced Incidence of Relapse and of Chronic Graft-versus-Host Disease Compared with HLA-Identical Related Donors
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T Cell-Replete Haploidentical Transplantation with Post-Transplantation Cyclophosphamide for Hodgkin Lymphoma Relapsed after Autologous Transplantation: Reduced Incidence of Relapse and of Chronic Graft-versus-Host Disease Compared with HLA-Identical Related Donors

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摘要

Allogeneic hematopoietic stem cell transplantation (SCT) represents a potential curative strategy for patients with Hodgkin lymphoma (HL) relapsing after autologous SCT (ASCT), but the incidence of disease relapse is still high. We performed a retrospective study on 64 patients with HL relapsing after ASCT to compare outcomes after HLA-identical SCT (HLAid-SCT; n?=?34) and haploidentical SCT with post-transplantation cyclophosphamide (PT-Cy) (Haplo-SCT; n?=?30). All patients engrafted, with a significantly shorter median time for neutrophil and platelet engraftment after HLAid compared with Haplo-SCT (14 days versus 19 days and 11 days versus 23 days, respectively; P
机译:同种异体造血干细胞移植(SCT)代表了在自体SCT(ASCT)后复发的霍奇金淋巴瘤(HL)患者的潜在治疗策略,但疾病复发的发生率仍然很高。我们对64例HL复发后的患者进行了回顾性研究,以比较HLA - 相同SCT(HLAID-SCT; N?= 34)和移植后环磷酰胺(PT-SCT)的HAPLoidentical SCT(HLO-SCT; n?=?30)。与HLAID相比,所有患者植入的患者中子粒细胞和血小板植入的时间明显较短(分别为14天,与23天为23天,分别为23天)。中位随访47个月,3年总体存活(OS),3年的无进展生存(PFS)和1年非卷中死亡率(NRM)分别为53%,44%和17% 。 HAPLO-SCT的接受者不太可能经历疾病复发(3年复发发病率,13%对62%; p =Δ.0001)和慢性接枝与宿主疾病(GVHD; 3%与32%相比; P = 003),导致改善的PFS(60%对29%; p =β.04)和无需/复发存活(47%与17%; P = 06)。 3年的OS在2组之间没有区别(56%对54%; P不显着),并且在HAPLO-SCT后NRM较高,但差异没有达到统计学意义(26%与9%; P = ?.09)。在多变量Cox回归分析中,收到HAPLO-SCT(危险比[HR],.17; P = 02)和实现最佳疾病控制(在SCT之前完全缓解:HR,.6; P <0001)唯一与降低疾病复发风险相关的独立变量。 HAPLO-SCT是ASCT后复发后复发的患者的有效选择,与HLAID SCT相比减少了复发的发生率。

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