异基因造血干细胞移植在复发难治淋巴瘤中的应用

The application of allogeneic hematopoietic stem cell transplantation in relapsed/refractory lymphoma

复发难治淋巴瘤的治疗仍然是临床上的一大难题,目前主要以大剂量化疗联合自体造血干细胞移植及新药、细胞免疫治疗为主。近年减低强度预处理方案异基因造血干细胞移植(allo-HSCT)及替代供者的应用,使allo-HSCT成为复发难治淋巴瘤有价值的治疗选择。疾病特征、患者临床特点、替代供者的选择、预处理强度及移植相关并发症的管理等因素均影响着患者移植后的生存。allo-HSCT治疗复发难治淋巴瘤的数据主要来源于各移植中心的回顾性报道,前瞻性试验仍缺乏,移植患者的选择及移植时机的把握、移植物来源、预处理强度的选择等仍无统一的标准。文章将围绕这些方面对allo-HSCT在复发难治淋巴瘤中的应用进展进行介绍。

The therapy of relapsed/refractory lymphoma is still a challenge,and high-dose chemotherapy combined with autologous stem cell transplantation,new drugs and cellular immunotherapy are the main treatment options.In recent years,the emergence of reduced intensity conditioning allogeneic hematopoietic stem cell transplantation(allo-HSCT)and alternative donor have made allo-HSCT become a valuable option for relapsed/refractory lymphoma.The features of the disease,patients'clinical characteristics,selection of alternative donors,conditioning regimen and the management of transplantation-related complications affect the survival of patients after transplantation.The data of allo-HSCT in the treatment of relapsed/refractory lymphoma are mainly derived from retrospective reports of various transplantation centers,and a large number of prospective clinical trials are desperately needed to explore.There are still no consensus for the selection criteria of transplant patients,the timing of transplantation,the selection of graft source and transplantation conditioning.This paper reviews the current progress of the application of allo-HSCT in relapsed/refractory lymphoma.