自体干细胞移植治疗T细胞淋巴瘤31例临床分析

Clinical analysis of Autologous stem cell transplantation in 31 cases of T cell lymphoma

目的探讨自体干细胞移植治疗T细胞淋巴瘤的疗效和预后因素。方法回顾性分析了2004年5月-2009年12月我院的31例自体干细胞移植的T细胞淋巴瘤的临床资料，观察3年总生存率（OS）和无进展生存率（PFS），分析一般状况（Ps）、乳酸脱氢酶（LDH）、移植前状况、分期、外周T细胞淋巴瘤（PTCL）预后指数（PIT）评分对生存的影响。结果中位随访时间为28（5～68）个月，1例患者死于严重肺部感染例（3．2％），12例复发（38．7％），3年PFS和OS分别为（56．7±1．2）％和（61．4±1．1）％。单因素分析结果示：移植前未达CR和PS〉2与不良的预后相关（P〈0．05）。多因素分析移植前未达CR是影响生存的独立危险因素（P〈0．05）。结论自体干细胞移植治疗T细胞淋巴瘤是安全和有效的，移植前未达到CR是影响T细胞淋巴瘤患者自体干细胞移植生存期的独立危险因素。

Objective To explore the effectiveness and prognostic factors of Autologous stem cell transplantation （ASCT） in patients with T cell lymphoma. Methods The clinical records of 31 patients T cell lymphoma treated in our hospital from 2003 to 2009 were retrospectively reviewed, the 3 - year overall survival （OS） and progression - free survival （PFS） rates were analyzed, We all analyzed the prognostic significance of performance status （PS） ,lactate dehydrogenase（LDH） ,disease status at transliant, stage, prognostic index of PTCL （PIT）. Results After a median follow - up of 28 （5 - 68 ） months, One patient died of serious lung infection （ 3.2% ）, 12 patients relapsed （ 38.7% ）. The 3 - year OS and PFS rates were （ 61.4 ± 1.1 ） % and （56. 7 ± 1.2 ） %, respectively. Univariate analysis showed that poor performance status, failure to achieve complete response （CR） at transplantation were associated with poor OS. Multivariate analysis showed that failure to achieve CR at transplantation were independent prognostic factors for OS. Conclusions ASCT in the treatment of T cell lymphoma is safe and effective. Failure to achieve CR at transplantation is the negative predictable factor for survival following HDT/ASCT in patients with T cell lymphoma.