自体造血干细胞移植治疗25例侵袭性外周T细胞淋巴瘤患者临床分析

OBJECTIVE: To investigate the outcomes of autologous stem cell transplantation (ASCT) for patients with aggressive peripheral T-cell lymphoma (PTCLs) in advanced stage. METHODS: The clinical data of 25 patients in complete remission (CR) with aggressive PTCLs received ASCT from May 1997 to June 2013 were retrospectively analyzed. RESULTS: ①Of the 25 cases, 16 were unspecified PTCL (PTCL-U), 4 with angioimmunoblastic T cell lymphoma (AITL), 3 with anaplastic large cell lymphoma (ALCL) and 2 with hepatosplenic T cell lymphoma (HSTL), with a median age of 30(12–54) years old. Ratio of male to female is 16:9. The distribution of stages was 8 cases with stage Ⅲ and 17 patients with stage Ⅳ. Nine patients presented with bone marrow involvement. Before ASCT, 18 patients were in CR(1) and 7 patients were in CR(2). ②Two patients with HSTL in stage ⅣB and IPI score 4/5 in CR(1) relapsed and died within 12 months after ASCT. At a median follow-up of 38 (range 14–110) months, the estimated 3-year probability of PFS and OS for the other 23 patients was (63.1±10.5)% and (71.8±9.9)%, respectively. The patients in first CR had a better survival than the patients in second CR. The 3-year probability of PFS were (74.9± 11.0)% vs (33.3± 19.2)% (P=0.092) and OS were (80.2± 10.4)% vs (50.0±20.4)% (P=0.043), respectively. The 3-year probability of PFS and OS were (40.0±17.4)% and (53.3±17.3)% in bone marrow involvement patients and the corresponding figure were (77.9±11.3)% and (84.4 ± 10.2)% in non-bone marrow involvement patients. CONCLUSION: ASCT could improve the survival of aggressive PTCLs. Non CR1 status and bone marrow involvement had negative influence on OS in patients with aggressive PTCLs treated by ASCT. The prognosis was very poor in patients with HSTL and satisfactory regimens should be investigated.