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
外周 T 细胞淋巴瘤患者中以 CD34+ 选择体外净化最大化自体干细胞移植效果的疗效
英文原题：Efficacy of ex vivo purging with CD34+ selection to maximize the effects of autologous stem cell transplantation in peripheral T-cell lymphoma patients.
查看英文原题
Efficacy of ex vivo purging with CD34+ selection to maximize the effects of autologous stem cell transplantation in peripheral T-cell lymphoma patients.
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研究概要
在接受 HDT/ASCT 的 PTCL 患者中，CD34+选择性净化改善了生存结局并降低了复发风险。该操作增加了 NK 细胞计数和 ASCT 后 LMR。CD34+选择性净化可能最大限度地减少自体移植物肿瘤细胞污染，并提高 T 细胞淋巴瘤的疗效。
研究思路结论见上方概要
背景
外周T细胞淋巴瘤（PTCL）是罕见且侵袭性强的肿瘤，其最佳治疗方案尚不明确。本研究探讨了PTCL患者接受CD34+选择性净化后大剂量化疗（HDT）继以自体干细胞移植（ASCT）的临床结局。
方法
回顾性分析纳入67例达到缓解并接受HDT/ASCT的PTCL患者。使用CliniMACS（Miltenyi Biotec，Bergisch Gladbach，德国）进行CD34+选择性净化。评估了生存结局、植入、淋巴细胞亚群和病毒感染。
结果
CD34+选择性净化自体移植物与未净化自体移植物相比，与显著改善的总生存期（OS）和无病生存期（DFS）相关（5年OS，73.3%对37.8%；5年DFS，73.8%对33.4%）。净化组的累积复发率也更低（31.5%对73.3%）。亚组分析显示，接受净化自体移植物的高危组具有显著的生存获益。淋巴细胞亚群分析显示，净化组在ASCT后自然杀伤（NK）细胞计数增加。ASCT后较高的淋巴细胞与单核细胞比值（LMR）与改善的OS和DFS相关。
展开英文摘要原文
METHODS
Retrospective analysis included 67 PTCL patients who achieved remission and underwent HDT/ASCT. CD34+ selective purging was performed using CliniMACS (Miltenyi Biotec, Bergisch Gladbach, Germany). Survival outcomes, engraftment, lymphocyte subsets and viral infections were evaluated.
RESULTS
CD34+ selective purged autografts were associated with significantly improved overall survival (OS) and disease-free survival (DFS) compared with unpurged autografts (5-year OS, 73.3% versus 37.8%, 5-year DFS, 73.8% versus 33.4%). The cumulative incidence of relapse was also lower in the purged group (31.5% versus 73.3%). Subgroup analysis revealed significant survival benefits in the high-risk group receiving purged autografts. Lymphocyte subset analysis showed increased natural killer (NK) cell counts in the purged group after ASCT. Higher post-ASCT lymphocyte-to-monocyte ratio (LMR) was associated with improved OS and DFS.
CONCLUSIONS
CD34+ selective purging in PTCL patients undergoing HDT/ASCT improved survival outcomes and reduced relapse risk. The procedure increased NK cell counts and post-ASCT LMR. CD34+ selective purging may minimize autograft tumor cell contamination and enhance efficacy in T-cell lymphomas.
论文信息
- 作者
- Jeon Y、Kim TY、Min GJ、Park SS、Park S、Yoon JH、Lee SE、Cho BS
- 第一作者单位
- Lymphoma and Cell Therapy-Research Center, Yeouido St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea; Catholic University Lymphoma Group, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea.South Korea
- 通讯作者单位
- Lymphoma and Cell Therapy-Research Center, Yeouido St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea; Catholic University Lymphoma Group, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea; Catholic Hematology Hospital, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea. Electronic address: chosg@catholic.ac.kr.South Korea
- 文献类型
- 非美国政府资助研究
- 期刊
- Cytotherapy2023 Dec
- 原文标识
- PubMed 37542512 · DOI 10.1016/j.jcyt.2023.07.005