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Autologous hematopoietic stem cell transplantation for relapsed/refractory systemic anaplastic large cell lymphoma. A retrospective analysis of the lymphoma working party (LWP) of the EBMT.

自体造血干细胞移植治疗复发性/难治性系统性间变性大细胞淋巴瘤。EBMT 淋巴瘤工作组 (LWP) 的回顾性分析。

  • 影响因子:2.48
  • DOI:10.1038/s41409-019-0734-7
  • 作者列表:"Domingo-Domènech E","Boumendil A","Climent F","Sengeloev H","Wahlin B","Wattad W","Arat M","Finel H","Schapp N","Ganser A","Yeshurun M","Pavone V","Snowden J","Finke J","Montoto S","Sureda A","Dreger P","Lymphoma Working Party of the European Society for Blood and Marrow Transplantation.
  • 发表时间:2020-04-01
Abstract

:Systemic anaplastic large cell lymphoma (sALCL) is a rare histological entity expressing the CD30 antigen that comprises around 11% of peripheral T-cell lymphoma. We analysed the outcome of patients with relapsed/refractory sALCL treated with autologous stem cell transplantation (auto-HCT). We included 65 adult patients (42 males; median age, 44 years); 24 patients had an ALK-ve sALCL. Fifty-one patients had chemosensitive disease at the time of transplant. Ten patients (15%) were treated with brentuximab vedotin (BV) before auto-HCT (median number of doses: 5). The median follow-up for surviving patients was 35 months (3-71). Three-year cumulative incidence of nonrelapse mortality and of relapse were 1.7% and 34%, respectively. Three-year progression-free survival and overall survival were 64% and 73%, respectively. No prognostic factors for any of the outcomes analysed were found in univariate analysis. There were no significant differences in any of the outcomes between patients who had received BV and the remainder. This is the largest analysis presented so far analysing the role of auto-HCT in patients with relapsed/refractory sALCL, showing a promising PFS and OS in this high-risk population. The potential impact of the administration of BV as salvage strategy before the procedure needs to be further elucidated.

摘要

: 系统性间变性大细胞淋巴瘤 (sALCL) 是一种表达 CD30 抗原的罕见组织学实体,约占外周 T 细胞淋巴瘤的 11%。我们分析了接受自体干细胞移植 (auto-HCT) 治疗的复发/难治性 sALCL 患者的结局。我们纳入了 65 例成人患者 (42 例男性; 中位年龄 44 岁); 24 例患者接受 ALK-ve sALCL。51 例患者在移植时患有化疗敏感性疾病。10 例患者 (15%) 在 auto-HCT 前接受了 brentuximab vedotin (BV) 治疗 (中位剂量数: 5)。存活患者的中位随访时间为 35 个月 (3-71)。非复发死亡率和复发的三年累积发生率分别为 1.7% 和 34%。三年无进展生存率和总生存率分别为 64% 和 73%。单变量分析中未发现任何预后因素。接受 BV 的患者与接受 BV 的其余患者之间的任何结局没有显著差异。这是迄今为止介绍的最大的分析,分析了 auto-HCT 在复发/难治性 sALCL 患者中的作用,显示了在该高危人群中有希望的 PFS 和 OS。术前给予 BV 作为补救策略的潜在影响需要进一步阐明。

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