Abstract:
Hepatosplenic T-cell lymphoma (HSTCL) is a rare and aggressive type of peripheral T-cell lymphoma with median overall survival (OS) of approximately 1 year. Data on the effectiveness of hematopoietic cell transplantation (HCT) is limited, as is the choice between autologous HCT (auto-HCT) and allogeneic HCT (allo-HCT) in the treatment of this disease. To evaluate the outcome of patients with HSTCL who underwent either auto-HCT or allo-HCT, we performed a multi-institutional retrospective cohort study to assess outcomes of HCT in HSTCL patients. Fifty-three patients with HSTCL were included in the study. Thirty-six patients received an allo-HCT and 17 received an auto-HCT. Thirty-five (66%) were males. Median age at diagnosis was 38 (range 2 to 64) years. Median follow-up for survivors was 75 months (range 8 to 204). The median number of prior lines of therapy was 1 (range 1 to 4). Median OS and progression-free survival (PFS) for the entire cohort were 78.5 months (95% CI: 25 to 79) and 54 months (95% CI: 18 to 75), respectively. There were no significant differences in OS (HR: 0.63, 95% CI: 0.28 to 1.45, P = .245) or PFS (HR: 0.7, 95% CI: 0.32 to 1.57, P = .365) between the allo-HCT and auto-HCT groups, respectively. In the allo-HCT group, the 3-year cumulative incidence of relapse was 35% (95% CI: 21 to 57), while 3-year cumulative incidence of NRM was 16% (95% CI: 7 to 35). In the auto-HCT group, the 3-year cumulative incidence of relapse and NRM were 43% (95% CI: 23 to 78) and 14% (95% CI: 4 to 52), respectively. Both Auto-HCT and Allo-HCT are effective consolidative strategies in patients with HSTCL, and patients should be promptly referred for HCT evaluation.
摘要:
背景:肝脾T细胞淋巴瘤(HSTCL)是一种罕见且侵袭性的外周T细胞淋巴瘤,中位总生存期(OS)约为1年。关于造血细胞移植(HCT)有效性的数据有限,在这种疾病的治疗中,自体HCT(auto-HCT)和同种异体HCT(allo-HCT)之间的选择也是如此。
目的:评估接受auto-HCT或allo-HCT的HSTCL患者的预后。
方法:我们进行了一项多机构回顾性队列研究,以评估HSTCL患者的HCT结局。
结果:53例HSTCL患者被纳入研究。36例患者接受了allo-HCT,17例接受了auto-HCT。35(66%)是男性。诊断时的中位年龄为38岁(范围2-64岁)。幸存者的中位随访时间为75个月(范围8-204)。先前治疗线的中位数为1(范围1-4)。整个队列的中位OS和无进展生存期(PFS)分别为78.5个月(95%CI:25-79)和54个月(95%CI:18-75)。分别。allo-HCT组和auto-HCT组的OS(HR:0.63,95%CI:0.28-1.45,p=0.245)或PFS(HR:0.7,95%CI:0.32-1.57,p=0.365)无显著差异,分别。在allo-HCT组中,3年累积复发率为35%(95%CI:21-57),而NRM的3年累积发生率为16%(95%CI:7-35)。在auto-HCT组中,3年累积复发率和NRM分别为43%(95%CI:23-78)和14%(95%CI:4-52),分别。
结论:Auto-HCT和Allo-HCT都是HSTCL患者的有效巩固策略,患者应及时转诊进行HCT评估。