自体造血干细胞移植治疗T淋巴母细胞淋巴瘤41例临床研究

OBJECTIVE: To investigate the efficacy and predictors of autologous hematopoietic stem cell transplantation（auto-HSCT）in the treatment of T lymphoblastic lymphoma（T-LBL）. METHODS: 41 patients with T-LBL who underwent auto-HSCT from April 2006 to July 2017 in the Department of Hematology, the First Affiliated Hospital of Soochow University and the Department of Lymphoma, Peking University Cancer Hospital were analyzed retrospectively. RESULTS: ①Among 41 patients, there were 30 males and 11 females with median age of 24 (11–53) years old. According to the Ann Arbor staging, 33 (80.5％) patients were in stage Ⅲ/Ⅳ. 12 (29.3％) patients have mediastinal involvement, and 20 (48.8％) patients have bone marrow (BM) involvement. Before transplantation, there were 26 (63.4％) patients who achieved first complete remission (CR(1)), the other 15 (36.6％) patients were in the non-CR(1) group, and there were 29 (70.7％) patients in the low-intermediate risk group (IPI<3 scores), the other 12 (34.1％) patients were in the middle-high risk group (IPI≥3 scores). ②The median follow-up was 29 (3–98) months. The 3-year overall survival (OS) and progression-free survival (PFS) for 41 patients were (64.3±8.2)％ and (66.0±7.8)％, respectively. 3-year cumulative recurrence rate (CIR) was (30.7±7.4)％, and 3-year non-recurring mortality (NRM) was (4.8±4.6)％. ③The 3-year OS of the CR(1) group and the non-CR(1) group were (83.4±7.6)％ and (38.9±12.9)％ (P＝0.010), and the 3-year PFS of two groups were (83.8±7.4)％ and (40.0±12.6)％ (P＝0.006), respectively. The 3-year CIR of these two groups were (16.2±7.4)％ and (53.3±12.9)％ (P＝0.015), and the 3-year NRM were 0 and (14.3±13.2)％ (P＝0.157), respectively. ④The 3-year OS of the IPI low-intermediate risk group and the high-intermediate risk group were (76.9±8.4)％ and (35.7±15.2)％ (P＝0.014) and the 3-year PFS were (77.4±8.2)％ and (40.0±14.6) (P＝0.011), respectively. The 3-year CIR of these two groups were (18.1±7.3)％ and (60.0±14.6)％ (P＝0.006), and the 3-year NRM were (5.6±5.4)％ and 0 (P＝0.683), respectively. The OS and PFS of patients with low-intermediate risk group were significantly higher than the other group. CONCLUSION: Auto-HSCT could improve the survival of T-LBL. Pre-transplant status and IPI score are important predictors for survival T-LBL patients with auto-HSCT.