自体造血干细胞移植对B细胞非霍奇金淋巴瘤的预后因素分析

Prognostic factors for patients with B-cell non-hodgkin lymphoma undergoing autologous stem cell transplantation

目的探讨与B细胞非霍奇金淋巴瘤(NHL)自体造血干细胞移植(ASCT)相关的预后因素。方法回顾性分析21例在青岛市中心医院接受ASCT的复发难治性B细胞NHL患者的临床资料。将无进展生存时间(PFS)及总生存时间(OS)作为观测指标。OS、PFS采用Kaplan-Meier曲线法计算。采用Cox比例风险回归模型对可能影响预后的因素进行单因素及多因素分析。结果 21例患者ASCT前完全缓解(CR)率为52﹪,移植后上升至67﹪。所有患者的中位生存时间为25个月,2年总生存率为52﹪,2年无进展生存率为48﹪。2年累计的无复发死亡率为5﹪,复发死亡率为43﹪。单因素风险分析的结果显示,与OS和PFS相关的有利因素包括:PET/CT CR、初治时使用利妥昔单抗;多因素分析显示,移植前PET/CT CR是影响OS和PFS的独立危险因素。结论 ASCT治疗复发难治性B细胞NHL疗效良好,移植前PET/CT扫描达CR状态是ASCT的有利预后因素。

Objective This study was aimed to investigate prognosis factors related to B-cell NHL patients who received ASCT. Methods Retrospective analysis of 21 cases of recurrence and refractory B-cell NHL patients who received ASCT in department of Hematology, Qingdao Central Hospital. Progression-free survival（PFS）and overall survival（OS）as observation index. PFS and OS were computed by Kaplan-Meier curve. Single factor and multiple factors analysis was carried out by Cox hazards regression model to investigate prognosis factors. Results The CR rate before ASCT was 52 ﹪, and it rose to 67 ﹪ after transplantation. The median survival time of all patients was 25 months. The 2-year OS rate was 52 ﹪ and the 2-year PFS was 48 ﹪. Univariate analysis showed that PET/CT CR, firstline therapy including Rituximab, and IPI score were related with OS and PFS. However, multivariate analysis showed that PET/CT CR before transplantation was independent risk factor of OS and PFS. Conclusion Our results suggest that ASCT is effective and safe for patients with B-cell NHL, and PET/CT scan before transplantation is an important prognostic indicator of ASCT.