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
套细胞淋巴瘤的异基因干细胞移植；新型免疫治疗和靶向治疗时代其潜在作用的见解：GETH/GELTAMO 经验
英文原题：Allogeneic Stem Cell Transplantation in Mantle Cell Lymphoma; Insights into Its Potential Role in the Era of New Immunotherapeutic and Targeted Therapies: The GETH/GELTAMO Experience.
查看英文原题
Allogeneic Stem Cell Transplantation in Mantle Cell Lymphoma; Insights into Its Potential Role in the Era of New Immunotherapeutic and Targeted Therapies: The GETH/GELTAMO Experience.
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中文摘要
异基因造血干细胞移植（allo-SCT）可作为部分复发/难治性（R/R）套细胞淋巴瘤（MCL）患者的根治性选择，但非复发死亡率（NRM）较高。本文报告 1995 年 3 月至 2020 年 2 月在西班牙接受 allo-SCT 患者的长期结局。主要终点为无事件生存期（EFS）、总生存期（OS）以及 NRM、复发和移植物抗宿主病（GVHD）的累积发生率（CI）。共纳入 135 例患者，其中大多数（85%）接受减低强度预处理（RIC）。中位随访 68 个月后，5 年 EFS 和 OS 分别为 47% 和 50%。总体缓解率和完全缓解率分别为 86% 和 80%。1 年和 3 年复发 CI 分别为 7% 和 12%。
第 100 天和 1 年 NRM 分别为 17% 和 32%。既往自体 SCT 和 3–4 级急性 GVHD（aGVHD）与较高 NRM 相关。3–4 级 aGVHD、供者类型（非亲缘不匹配供者）及 2006–2020 年治疗时期分别独立关联较差 EFS。1995–2005 年接受移植的患者年龄较小，多数使用 HLA 相合同胞供者，且既往治疗较少。数据证实 allo-SCT 可作为 R/R MCL 的根治性选择，复发 CI 较低，但 NRM 仍高，主要继发于 aGVHD。随着高效、低毒性免疫疗法和靶向疗法出现，allo-SCT 将不可避免地转为用于不适合或经这些疗法治疗失败的患者，治疗时机将不再理想。
展开英文摘要原文
Allo-SCT is a curative option for selected patients with relapsed/refractory (R/R) MCL, but with significant NRM.
We present the long-term results of patients receiving allo-SCT in Spain from March 1995 to February 2020. The primary endpoints were EFS, OS, and cumulative incidence (CI) of NRM, relapse, and GVHD.
We included 135 patients, most (85%) receiving RIC. After a median follow-up of 68 months, 5-year EFS and OS were 47 and 50%, respectively.
Overall and CR rates were 86 and 80%. The CI of relapse at 1 and 3 years were 7 and 12%. NRM at day 100 and 1 year were 17 and 32%. Previous ASCT and Grade 3-4 aGVHD were associated with a higher NRM. Grade 3-4 aGVHD, donor type (mismatch non-related), and the time-period 2006-2020 were independently related to worse EFS. Patients from 1995-2005 were younger, most from HLA-identical sibling donors, and were pretreated less.
Our data confirmed that allo-SCT may be a curative option in R/R MCL with low a CI of relapse, although NRM is still high, being mainly secondary to aGVHD. The arrival of new, highly effective and low toxic immunotherapeutic or targeted therapies inevitably will relegate allo-SCT to those fit patients who fail these therapies, far away from the optimal timing of treatment.
论文信息
- 作者
- Gutierrez A、Bento L、Novelli S、Martin A、Gutierrez G、Queralt Salas M、Bastos-Oreiro M、Perez A
- 第一作者单位
- Son Espases University HospitaI, IdISBa, 07120 Palma, Spain.Spain
- 期刊
- Cancers2022 May 27
- 原文标识
- PubMed 35681653 · DOI 10.3390/cancers14112673
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