异基因造血干细胞移植治疗T淋巴母细胞性淋巴瘤10例临床观察

Allogeneic Hematopoietic Stem Cell Transplantation for Treatment of T Cell Lymphoblastic Lymphoma——Clinical observation of 10 Cases

目的:探讨异基因造血干细胞移植(allo-HSCT)治疗T淋巴母细胞性淋巴瘤(T-LBL)患者的临床疗效和安全性。方法:通过对10例T-LBL患者接受allo-HSCT后造血重建、移植物抗宿主病(GVHD)、感染、复发及生存情况的观察,分析allo-HSCT治疗T-LBL的临床疗效。结果:10例T-LBL患者,男性6例,女性4例,中位年龄25(18-41)岁,临床分期为Ⅲ期1例,Ⅳ期患者9例,合并骨髓侵犯者7例。10例移植患者中,非亲缘全相合移植3例,同胞相合移植3例,同胞单倍体相合移植2例,亲缘单倍体相合移植2例。10例患者移植后造血功能均顺利重建,粒系植入中位时间11(10-19)d,巨核系植入中位时间12(7-19)d。10例患者有5例发生急性移植物抗宿主病(aGVHD),1例患者发生慢性移植物抗宿主病(c GVHD)。中位随访时间26(11-51)月,3例患者死亡,其中1例患者因移植后复发死亡,2例患者各因aGVHD和移植后感染死亡。T-LBL患者行allo-HSCT后,复发率10%,移植相关死亡率20%,总体生存率(OS)70%,无病生存率(DFS)70%,预期2年OS率66.7%。结论:T-LBL复发率较高,预后较差,allo-HSCT可以改善T-LBL患者的生存,是治疗T-LBL患者的有效手段。

Objective：To analyze the result of allogeneic hematopoietic stem cell transplantation（allo-HSCT） for treatment of patients with T cell Lymphoblastic lymphoma（T-LBL）.Methods：The engraftment,graft versus host disease（GVHD）,infection,relapse and survival of 10 T-LBL patients received allo-HSCT was observed.The clinical outcome of allo-HSCT for T-LBL patients was analyzed.Results：The median age of patients was 25 years old,10（6males and 4 females） T-LBL patients received allo-HSCT including 3 from HLA-matched unrelated donors,3 from HLA-matched sibling donors,2 from HLA haploidentical sibling donors,and 2 from haploidentical related donors.The clinical staging showed that 1 case was in stage Ⅲ and 8 cases were in stage Ⅳ.The bone marrow was involved in 7patients.All the 10 patients achieved engraftment,and the median times of neutrophil and platelet engraftment were 11（10- 19） days and 12（7- 19） days,respectively.Acute GVHD occurred in 5 patients and chronic GVHD occured in 1patient.After the median follow-up of 26 months（11-51 months）,3 patients died,out of them 1 died from relapse after transplantation,1 from infection and 1 from GVHD.The relapse,overall survival,and disease-free survival rate were 10%,70%,70%,respectively.And the estimated overall survival rate was 66.7%.Conclusion：T-LBL has high rate of relapse and poor prognosis.The allo-HSCT can improve the survival of patients with T-LBL,and is an effective method for treatment of T-LBL patients.