摘要
目的探讨自体造血干细胞移植治疗复发难治性外周T细胞淋巴瘤的临床疗效及预后因素。方法选择2010年1月—2016年1月宁波市鄞州人民医院接收的复发难治性外周T细胞淋巴瘤患者64例,均采用自体造血干细胞移植进行治疗,分析治疗效果、临床特征,采用COX回归进行预后分析。结果64例患者在自体干细胞移植后15 d内造血重建,采集中位外周单个核细胞为8.74×10^8/kg(6.34×10^8-16.72×10^8/kg),中位CD34^+细胞数为5.64×10^6/kg(3.43×10^6-9.62×10^6/kg)。中性粒细胞植入(>0.5×10^9/L)中位时间12 d(7-17 d),血小板植入(恢复20×10^9/L)中位时间13 d(7-19 d)。随访中位时间26个月(8-48个月),截止到随访结束,死亡28例,其中24例为复发患者,4例移植相关并发症死亡,死亡率为43.75%,生存率为56.25%。28例(43.75%)患者移植后达CR,21例(32.81%)患者为PR,14例(21.88%)为SD。3年总生存率为59.38%,3年无进展生存率为48.44%,最长无病生存时间达41个月。多因素COX回归分析显示,骨髓累及、PIT评分、移植后是否获得CR是不良预后的独立影响因素。结论自体造血干细胞移植对复发难治性外周T细胞淋巴瘤效果显著,骨髓累及、PIT评分、移植后是否获得CR是不良预后的影响因素。
Objective To investigate the clinical effect and prognostic factors of autologous hematopoietic stem cells transplantation(AHSCT)in the treatment of recurrent refractory peripheral T cell lymphoma.Methods Sixty-four cases of recurrent refractory peripheral T cell lymphoma admitted in Yinzhou people’s Hospital between January 2010 and January 2016 received AHSCT treatment.The patients were followed up for the analysis of therapeutic effect and clinical characteristics,and the prognosis was analyzed by COX regression.Results Hematopoietic reconstitution in 64 patients within 15 days after AHSCT was observed.The median peripheral mononuclear cells were 8.74×10^8/kg(6.34×10^8-16.72×10^8/kg),the median CD34 cell count was 5.64×10^6/kg(3.43×10^6-9.62×10^6/kg).The median time of neutrophil implantation(>0.5×10^9/L)was 12 d(7-17 d),the median time of platelet implantation(20×10^9/L)was 13 d(7-19 d).The median time of follow-up was 26 months(8-48 months).By the end of the follow-up period,28 cases of them died,the death rate was 43.75%(survival rate 56.25%);24 cases died of recurrence and 4 cases died of transplantation related complications.Response rates:complete response(CR)43.75%(28/64),partial response(PR)32.81%(21/64),stable disease(SD)21.88%(14/64).The 3-years overall survival was 59.38%.Three-year progression-free survival rate was 48.44%,the longest disease-free survival time was 41 months.Multivariate COX regression analysis showed that bone marrow involvement,the Prognostic Index for T-cell lymphoma(PIT)and complete response after AHSCT were independent factors of poor prognosis.Conclusion AHSCT has a significant effect on recurrent refractory peripheral T cell lymphoma.The bone marrow involvement,PIT score and CR after the transplantation will give a bad prognosis.
作者
陈冬
裴仁治
陆滢
曹俊杰
陈列光
刘旭辉
张丕胜
刘辉
CHEN Dong;PEI Ren-zhi;LU Ying;CAO Jun-jie;CHEN Lie-guang;LIU Xu-hui;ZHANG PI-sheng;LIU Hui(Department of Hematology,the People's Hospital of Yinzhou,Ningbo,Zhejiang 315040,China;不详)
出处
《中华全科医学》
2020年第1期59-61,157,共4页
Chinese Journal of General Practice
基金
浙江省自然科学基金(LY18H160008).
关键词
淋巴瘤
自体造血干细胞移植
回归分析
随访研究
Lymphoma
Autologous hematopoietic stem cells transplantation
Regression analysis
Follow-Up studies
作者简介
通信作者:陈冬,E-mail:chendong0218@163.com
