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外周T细胞淋巴瘤(PTCL),其免疫表型提示来源于胸腺后(或成熟)T细胞,包括大组非特异性PTCL。在全球范围内,PTCL约占非霍奇金淋巴瘤(NHL)的10%,在我国约占20%～30%,明显高于西方国家。大多数PTCL侵袭性强,恶性程度高,传统的化疗方法与B细胞NHL相比疗效不佳、预后不良,5年生存率低。近年来研究表明造血干细胞移植(HSCT)对PTCL有较好的疗效,优于传统的化疗方法。本文主要总结自体造血干细胞移植(ASCT)、异基因造血干细胞移植(allo-SCT)和自体外周血干细胞移植联合自体骨髓移植(APBHSCT+ABMT)三种方式及其优劣。ASCT无供受者之间的免疫排斥反应,造血重建快,但其复发率相对较高;allo-SCT具有移植物抗淋巴瘤作用,但其有较高的治疗相关死亡率;APBHSCT+ABMT对于年龄偏大、造血功能差而难以采集足够外周血干细胞、有潜在出血和感染风险较大的PTCL患者意义较大。HSCT的移植方法、移植时机、预处理方案及强度等多种因素对移植疗效均有影响,如何根据不同PTCL患者的具体情况选择不同的移植方式、选择合适的移植时机等问题还值得进一步深入的研究。
Peripheral T-cell lymphoma (PTCL), whose immunophenotypic cues are derived from post-thymus (or mature) T cells, includes a large group of nonspecific PTCLs. Globally, PTCL accounts for about 10% of non-Hodgkin’s lymphoma (NHL), about 20% to 30% in China, significantly higher than in Western countries. Most PTCL aggressive, high degree of malignancy, the traditional chemotherapy and B cell NHL poor efficacy, poor prognosis, 5-year survival rate is low. In recent years, studies have shown that hematopoietic stem cell transplantation (HSCT) has a good effect on PTCL, better than the traditional chemotherapy. This article summarizes the advantages and disadvantages of three methods of autologous hematopoietic stem cell transplantation (ASCT), allogeneic hematopoietic stem cell transplantation (allo-SCT) and autologous peripheral blood stem cell transplantation combined with autologous bone marrow transplantation (APBHSCT + ABMT). Allo-SCT has graft-versus-lymphoma effect, but has a higher treatment-related mortality rate; APBHSCT + ABMT has a significantly higher relapse rate Older age, poor hematopoietic function and difficult to collect enough peripheral blood stem cells, there is a potential risk of bleeding and infection greater significance of PTCL patients. HSCT transplant methods, the timing of transplantation, pre-treatment programs and intensity and other factors have an impact on the efficacy of transplantation, how to choose different methods of transplantation according to the specific situation of patients with different PTCL, select the appropriate timing of transplantation is also worth further the study.