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Clin Cancer Res:滤泡性淋巴瘤患者接受alloSCT或autoSCT后随访9年的结果

2021-08-16 Nebula MedSci原创

对于复发性滤泡性淋巴瘤患者,与autoSCT相比,alloSCT具有治愈性,并能提供更高的生存率

滤泡性淋巴瘤 (FL) 占非霍奇金淋巴瘤病例的20-30%。虽然在过去数十年中,治疗效果不断提高,但大多数FL患者经一线治疗获得初步缓解后会经历疾病复发。 造血干细胞移植仍是这类复发FL患者的重要治疗选择。

本研究旨在比较接受非清髓性异基因造血干细胞移植 (alloSCT) 和接受自体造血干细胞移植 (autoSCT) 的复发性FL 患者的预后。

纳入了在MD Anderson癌症中心进行造血干细胞移植的194位FL患者,其中98位接受的是alloSCT,96位接受的是autoSCT。所使用的移植类型是基于捐赠者的可用性和医疗保险报销指南。AlloSCT组患者参加了4项连续试验,在这些试验中他们接受了氟达拉滨、环磷酰胺(或苯达莫司汀)和利妥昔单抗调理。AutoSCT组患者接受了 R-BEAM方案(利妥昔单抗、卡莫司汀、依托泊苷、阿糖胞苷和美法仑)调理。

复发性FL患者接受autoSCT或alloSCT后的OS和PFS

alloSCT组幸存者的中位随访时间为108个月,autoSCT组的为102个月。alloSCT组患者的总生存率明显长于autoSCT组患者(62% vs 46%;p=0.048)。相似的,alloSCT组患者的无进展生存率也明显长于autoSCT组患者(52% vs 31%;p<0.001);alloSCT组患者的8年复发率明显低于autoSCT组患者(11% vs 43%;p<0.0001)。在长达3.5年时间内,alloSCT组只有3位患者病情复发。

累积复发率

在alloSCT组中,2-4级急性移植物抗宿主病(GVHD)、3-4级急性GVHD和慢性GVHD的发生率分别是22%、9%和38%。在autoSCT组中,继发性骨髓增生异常的8年发生率为11%。两组间的8年累积非复发性死亡率相似(15% vs 11%;p=0.27)。

简而言之,该研究显示,对于复发性滤泡性淋巴瘤患者,与autoSCT相比,alloSCT具有治愈性,并能提供更高的生存率

原始出处:

Issa F. Khouri, et al. 9-year follow-up of patients with relapsed follicular lymphoma after nonmyeloablative allogeneic stem cell transplant and autologous transplant. Clin Cancer Res August 11 2021 DOI:10.1158/1078-0432.CCR-21-1377

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    2021-08-29 14674335m17暂无昵称

    自体移植仍然是淋巴瘤的重要治疗手段

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    2021-08-18 仁医06

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