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目的探讨双次自体造血干细胞移植(autologous peripheral blood stem cell transplant,APSCT)治疗T淋巴母细胞淋巴瘤的临床疗效和安全性。方法收集2008年2月至2013年11月在我院血液病中心接受双次APSCT的T淋巴母细胞淋巴瘤患者共21例,中位年龄29岁。按照Ann Arbor标准,Ⅲ期5例,Ⅳ期16例,第1次移植前处于完全缓解(complete remission,CR)16例,部分缓解(partial remission,PR)为5例。第1次移植采用以环己亚硝脲+依托泊苷+阿糖胞苷+环磷酰胺联合方案进行预处理,以上患者在第1次移植后4~6个月进行第2次造血干细胞移植,预处理方案为伊达比星+阿糖胞苷+环磷酰胺。结果 1所有患者双次自体移植后造血功能均顺利重建。2中位随访24个月,复发3例,死亡4例(因复发死亡2例,疾病进展死亡1例,移植相关死亡1例),无病存活12例,4例疾病稳定,1例研究截止时疾病复发进展。3年预期无进展生存为68.9%,总生存率为73.6%。3预后相关因素中,患者的年龄、第1次移植后疾病状态是否CR影响患者的总生存期(overall survival,OS)和无进展生存期(progression-free survival,PFS),第1次移植前疾病状态是否CR影响患者的OS。结论双次APSCT治疗T淋巴母细胞淋巴瘤患者疗效确切,造血重建顺利,移植相关死亡率低,安全性好。
Objective To investigate the clinical efficacy and safety of autologous peripheral blood stem cell transplantation (APSCT) in the treatment of T lymphoblastic lymphoma. Methods Twenty-one patients with T lymphoblastic lymphoma who received double APSCT at the Hematology Center of our Hospital from February 2008 to November 2013 were recruited. The median age was 29 years. According to the Ann Arbor criteria, 5 were in stage III and 16 in stage IV, 16 were in complete remission (CR) and 5 in partial remission (PR). The first transplantation with cycloheximide nitrous oxide + etoposide + cytarabine + cyclophosphamide combination regimen for pre-treatment, the above patients in the first 4 to 6 months after transplantation for the second hematopoietic stem cell transplantation , Pretreatment program for the idarubicin + cytarabine + cyclophosphamide. Results 1 All patients were successfully reconstructed with hematopoietic function after double autograft. 2 were followed up for 24 months, 3 were relapsed, 4 died (2 died due to recurrent disease, 1 died due to disease progression, 1 died from transplantation), 12 survived without disease, 4 had stable disease and 1 died from the study When the disease recurred. 3 years expected progression-free survival was 68.9%, the overall survival rate was 73.6%. Among the prognostic factors, the age of the patient and whether the disease state after the first transplant affected the overall survival (OS) and progression-free survival (PFS) of patients, and before the first transplant Whether the disease state affects the patient’s OS is CR. Conclusions The double APSCT treatment of T lymphoblastic lymphoma patients with effective curative, hematopoietic reconstructed smoothly, transplantation-related mortality is low, good safety.