双次自体造血干细胞移植治疗T细胞非霍奇金淋巴瘤疗效观察

Double autologous hematopoietic stem cell transplantation for T cell non-Hodgkin's lymphoma

目的:评价自体造血干细胞移植治疗T细胞非霍奇金淋巴瘤的临床疗效及安全性。方法:回顾性分析T细胞非霍奇金淋巴瘤28例患者的资料,其中单次移植5例,双次移植23例。第1次移植预处理方案分别为:IEP方案19例,MiFAP方案9例。第2次移植预处理方案分别为:IEP方案9例,MiFAP方案14例。2次移植间隔为8(6～10)周。结果:所有患者均获得造血功能重建。无一例移植相关死亡。随访至2011年2月1日,中位随访时间28(2～98)个月。复发8例,经治疗无效均于复发后1～6个月死亡。5例单次移植患者复发3例(60%),23例双次移植患者复发5例(21.7%)。23例双次移植患者1年、3年预期生存率分别为95.7%和76.1%,1年、3年预期无进展生存率分别为95.7%和71.5%。23例双次移植患者预期中位无进展生存时间60个月,5例单次移植患者预期中位无进展生存时间18个月。结论:双次移植对预后不良、化疗效果欠佳的T细胞非霍奇金淋巴瘤疗效良好,安全性好。

Objective：To evaluate the clinical efficacy and safety of autologous hematopoietic stem cell trans- plantation （AHSCT） for the aggressive T cell non-Hodgkin＇s lymphoma （T-NHL）. Method： We reported and ana- lyzed 28 patients with aggressive T NHL retrospectively. The first conditioning regimen was 19 of IEP and 9 of MiFAP. Twenty-three patients received the second AHSCT in 6-- 8 weeks after the first AHSCT. The condition- ing regimen was 9 of IEP and 14 of MiFAP. Result：All engrafted patients had rapid hematopoietic reconstitution. There was no AHSCT related death. All patients were followed-up to February lst,2011. The median follow-up duration was 28 （2--98） months. Eight patients relapsed and then died in 1--6 months,of which 3 had received single AHSCT （SASHCT）,and 5 had received double AHSCT （DASHCT）. Among 23 patients who had received DASHCT,the 1 and 3 years overall survival （OS） was 95.7~ and 76.1~ ,while the 1 and 3 years progression free survival （PFS） was 95.7~ and 71.5~, respectively. Median DFS time was 60 months for the DAHSCT group and was 18 months for the SAHSCT group. Conclusion： DASHCT in tandem for aggressive T cell lymphoma is probably safe and effective.