复发性或难治性弥漫大 B 细胞淋巴瘤异基因造血干细胞移植的结局

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a currative treatment modality for diffuse large B-cell lymphoma (DLBCL) because of the intrinsic graft-versus-lymphoma effect.

However, limited information is available regarding which patients with relapsed or refractory DLBCL are likely to benefit from allo-HSCT.

We retrospectively analyzed data from 1268 DLBCL patients who received allo-HSCT. The overall survival and progression-free survival (PFS) rates were 30. 3% and 21. 6% at 3 years, respectively. Multivariate analysis revealed that stable or progressive disease at transplantation, male patient, poorer performance status at transplantation, and shorter intervals from previous transplantation were associated independently with a lower PFS. Four prognostic factors were used to construct a prognostic index for PFS, predicting 3-year PFS of 55. 4%, 43. 7%, 20.

4% and 6. 6%, respectively. The prognostic model predicted relapse rates following allo-HSCT accordingly (P < 0. 0001), whereas did not predict transplantation-related mortality (P = 0. 249).

The prognostic index can identify a subgroup of DLBCL patients who benefit from allo-HSCT and it is worthwhile to evaluate whether this model is also applicable to patients undergoing allo-HSCT in cases of relapse after chimeric antigen receptor engineered T-cell therapy, although the application of allo-HSCT has been declining with the increase of novel immunotherapies.