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
自体造血干细胞移植对中国外周 T 细胞淋巴瘤患者的疗效：一项倾向性评分匹配分析
英文原题：Effect of autologous hematopoietic stem cell transplantation for patients with peripheral T-cell lymphoma in China: A propensity score-matched analysis.
查看英文原题
Effect of autologous hematopoietic stem cell transplantation for patients with peripheral T-cell lymphoma in China: A propensity score-matched analysis.
分数与星级只用于站内排序 —— 不代表疗效、安全性或个人适用性。
研究概要
ASCT 可能改善首次 CR 或 PR 的 PTCL 患者的长期生存，尤其是血管免疫母细胞性 T 细胞淋巴瘤患者。
中文摘要
背景
对首次完全缓解（CR1）或部分缓解（PR1）的外周T细胞淋巴瘤（PTCL）患者，采用自体造血干细胞移植（ASCT）巩固治疗的作用仍有争议，中国相关数据有限。本研究旨在评估北京大学医院与研究所接受诱导化疗后应答的中国PTCL患者中，ASCT对生存的影响。
方法
回顾性分析1996至2020年间处于CR1或PR1的PTCL患者（不包括NK/T细胞淋巴瘤），并采用倾向评分匹配（PSM）平衡ASCT组与未接受ASCT组的临床特征。主要终点为无事件生存期（EFS）和OS。
结果
纳入的414例患者中，73例接受ASCT巩固治疗，341例未接受。中位随访5.7年，ASCT组生存显著优于未移植组（中位EFS 8.1年对2.8年，P=0.002；中位OS 14.9年对10.2年，P=0.007）。ASCT组5年EFS和OS率分别为68.4%和77.0%，未移植组分别为43.2%和57.6%。倾向评分匹配队列（46例接受ASCT、84例未接受）也证实了生存获益（中位EFS的P=0.007，中位OS的P=0.022）。Cox回归分析显示，ASCT与更好生存独立相关：EFS风险比（HR）0.46（95% CI 0.28–0.76），OS HR 0.50（95% CI 0.31–0.84）。亚组分析显示，高危及晚期患者更可能从ASCT获益。PTCL各亚型中，血管免疫母细胞性T细胞淋巴瘤的获益显著（EFS HR=0.26，95% CI 0.10–0.66；OS HR=0.29，95% CI 0.12–0.74），其他亚型未见显著获益。
结论
ASCT可能改善处于首次CR或PR的PTCL患者长期生存，尤其是血管免疫母细胞性T细胞淋巴瘤患者。仍需明确最可能从一线ASCT获益的具体人群。
展开英文摘要原文
BACKGROUND
The role of consolidation therapy with autologous stem cell transplantation (ASCT) in patients with peripheral T-cell lymphoma (PTCL) in first complete remission (CR1) or partial remission (PR1) remains controversial. The existing data from China are limited. Therefore, we aimed to investigate the effect of ASCT on the survival of Chinese patients with PTCL showing response to induction chemotherapy at our hospital.
METHODS
We retrospectively reviewed the data of patients with PTCL (excluding Natural killer/T cell lymphoma) in CR1 or PR1 treated at Peking University Hospital &Institute from 1996 to 2020. Propensity score matching (PSM) was used to balance clinical characteristics between the ASCT and non-ASCT groups. The primary endpoints were event-free survival (EFS) and overall survival (OS).
RESULTS
Of the 414 selected patients, 73 received ASCT consolidation and 341 did not. Over a median follow-up of 5.7 years, survival was significantly better in the ASCT group than in the non-ASCT group (median EFS, 8.1 years vs. 2.8 years, P = 0.002; median OS, 14.9 years vs. 10.2 years, P = 0.007). The 5-year EFS and OS rates were 68.4% and 77.0% in ASCT group, and 43.2% and 57.6% in non-ASCT group, respectively. The survival benefit was confirmed in the propensity score matched cohort (46 patients who received ASCT and 84 patients who did not receive ASCT): P = 0.007 for median EFS and P = 0.022 for the median OS. Cox regression analysis showed that ASCT was independently associated with better survival: hazard ratio (HR) for EFS, 0.46 (95% CI: 0.28-0.76); HR for OS, 0.50 (95% CI: 0.31-0.84). Subgroup analysis showed that ASCT was more likely to benefit higher-risk patients and those with advanced disease. Among the subtypes of PTCL, the benefit was significant in angioimmunoblastic T-cell lymphoma (HR = 0.26 [95% CI: 0.10-0.66] for EFS and 0.29 [95% CI: 0.12-0.74] for OS), but not in the other subtypes.
CONCLUSION
ASCT may improve the long-term survival of patients with PTCL in first CR or PR, especially for patients with angioimmunoblastic T-cell lymphoma. The specific groups most likely to benefit from upfront ASCT need to be clearly identified.
论文信息
- 作者
- Gao H、Wu M、Hu S、Ding N、Ji X、Mi L、Wang X、Song Y
- 单位
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing, China.China
- 期刊
- Frontiers in oncology2022
- 原文标识
- PubMed 36465366 · DOI 10.3389/fonc.2022.1039888
在 PubMed 查看 → 出版商原文（DOI） 全文 PDF（PMC）· 可下载 治疗专题与资料阅读指南 资料来源与翻译说明 报告译文或资料问题 →