不适合移植的大 B 细胞淋巴瘤二线使用 axicabtagene ciloleucel：ALYCANTE 最终分析
Second-line axicabtagene ciloleucel in large B-cell lymphoma ineligible for transplantation: ALYCANTE final analysis.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
无关供者脐血移植治疗成人起病 EBV 相关 T 细胞和 NK 细胞淋巴增殖性疾病
英文原题：Unrelated cord blood transplantation for adult-onset EBV-associated T-cell and NK-cell lymphoproliferative disorders.
查看英文原题
Unrelated cord blood transplantation for adult-onset EBV-associated T-cell and NK-cell lymphoproliferative disorders.
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中文摘要
成人起病的EB病毒相关T细胞和NK细胞淋巴增殖性疾病（EBV-T/NK-LPD）常进展迅速，治疗早期即需异基因干细胞移植。对于缺乏HLA相合供者的患者，无关供者脐带血移植（UCBT）是可及时获得的选择。
本研究回顾性分析12例成人UCBT结局，包括慢性活动性EBV感染（CAEBV，n=8）、原发EBV感染后EBV阳性噬血细胞性淋巴组织细胞增多症（n=2）、水痘样淋巴增殖性疾病（n=1）和儿童系统性EBV阳性T细胞淋巴瘤（STCLC，n=1）。移植时中位年龄为31.5岁（范围19至58岁）。存活者中位随访时间为6.3年（范围0.3至11.3年）；全体患者及8例CAEBV患者的3年总生存率分别为68.2%（95%置信区间［CI］28.6%–88.9%）和83.3%（95% CI 27.3%–97.5%）。8例CAEBV患者中有4例发生移植物失败，需再次进行UCBT以实现中性粒细胞植入。Ⅱ至Ⅳ级急性移植物抗宿主病（GVHD）的累积发生率为33.3%（95% CI 9.1%–60.4%）。所有病例UCBT后EBV-DNA载量均降至不可检出或极低水平。UCBT可能是成人起病EBV-T/NK-LPD的一种有前景治疗选择。
展开英文摘要原文
Adult-onset EBV-associated T-cell and NK-cell lymphoproliferative disorders (EBV-T/NK-LPDs) often progress rapidly, and require allogeneic stem cell transplantation early in the course of treatment. Unrelated cord blood transplantation (UCBT) is a readily available option for patients without HLA-matched donors.
We retrospectively analyzed the outcomes of 12 UCBT in adult patients with chronic active EBV infection (CAEBV, n = 8), EBV-positive hemophagocytic lymphohistiocytosis following primary EBV infection (n = 2), hydroa vacciniforme-like lymphoproliferative disorder (n = 1), and systemic EBV-positive T-cell lymphoma of childhood (STCLC, n = 1). The median age at transplantation was 31. 5 years (range 19-58). At the median follow-up time for survivors, which was 6. 3 years (range 0. 3-11.
3), 3-year overall survival (OS) rates in all patients and 8 CAEBV patients were 68. 2% (95% CI 28. 6-88. 9) and 83. 3% (95% CI 27. 3-97. 5), respectively. Graft failure occurred in 4 of 8 CAEBV patients, requiring a second UCBT to achieve neutrophil engraftment. The cumulative incidence of grade II-IV acute GVHD was 33. 3% (95% CI 9. 1-60. 4%). The EBV-DNA load became undetectable or very low after UCBT in all cases. UCBT may be a promising treatment option for adult-onset EBV-T/NK-LPDs.
论文信息
- 作者
- Onishi Y、Onodera K、Fukuhara N、Kato H、Ichikawa S、Fujiwara T、Yokoyama H、Yamada-Fujiwara M
- 单位
- Department of Hematology, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan. yonishi@med.tohoku.ac.jp.Japan
- 期刊
- International journal of hematology2022 Jun
- 原文标识
- PubMed 35274195 · DOI 10.1007/s12185-022-03313-z