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难治/复发性 B 细胞非霍奇金淋巴瘤患者自体造血干细胞移植联合 CAR-T 细胞治疗前卡莫司汀、依托泊苷、阿糖胞苷、美法仑(BEAM)方案与卡莫司汀、依托泊苷、阿糖胞苷、美法仑、氟达拉滨(BEAMF)方案的预后差异

英文原题:Prognostic differences between carmustine, etoposide, cytarabine and melphalan (BEAM) and carmustine, etoposide, cytarabine, melphalan and fludarabine (BEAMF) regimens before autologous stem cell transplantation plus chimeric antigen receptor T therapy in patients with refractory/relapsed B-cell non-Hodgkin-lymphoma.

查看英文原题

Prognostic differences between carmustine, etoposide, cytarabine and melphalan (BEAM) and carmustine, etoposide, cytarabine, melphalan and fludarabine (BEAMF) regimens before autologous stem cell transplantation plus chimeric antigen receptor T therapy in patients with refractory/relapsed B-cell non-Hodgkin-lymphoma.

PubMed 2024/02/19(内容时间) Cytotherapy Q1 · IF 4.5(JCR 2025)

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研究概要

对于 R/R B-NHL 患者,ASCT 前采用 BEAMF 方案联合 CD19/22 CAR-T 治疗相比 BEAM 方案与更优的 PFS 和 OS 相关,BEAMF 方案是 ASCT 联合 CAR-T 治疗的一种有前景的替代预处理方案。

研究思路结论见上方概要

自体造血干细胞移植(ASCT)联合CAR-T 细胞治疗已被用于改善复发/难治性(R/R)B细胞非霍奇金淋巴瘤(B-NHL)患者的预后。文献报道中,ASCT联合CAR-T 治疗前广泛使用的预处理方案为卡莫司汀、依托泊苷、阿糖胞苷和马法兰(BEAM)。然而,在BEAM方案中加入氟达拉滨(BEAMF)能否改善R/R B-NHL患者的生存尚不清楚。

总共纳入39例和19例R/R B-NHL患者,分别比较ASCT联合CD19/22 CAR-T 治疗前BEAM方案与BEAMF方案的临床结局。

ASCT前BEAM与BEAMF方案联合CD19/22 CAR-T 治疗的3个月客观缓解(OR)率分别为71.8%和94.7%(P = 0.093)。与BEAM方案相比,BEAMF方案在缓解持续时间方面显示出更优的趋势(P = 0.09)。中位随访28个月(范围:0.93-51.9个月)后,与BEAM方案相比,BEAMF方案显示出更优的2年无进展生存期(PFS)(89.5% vs 63.9%;P = 0.048)和2年总生存期(OS)(100% vs 77.3%;P = 0.035)。在多变量Cox回归分析中,与OR(非缓解者)相比,第3个月OR(缓解者)与更好的OS显著相关(风险比:0.112,P = 0.005)。

展开英文摘要原文

In total, 39 and 19 patients with R/R B-NHL were enrolled to compare clinical outcomes in the BEAM and BEAMF regimens before ASCT plus CD19/22 CART therapy, respectively.

The objective response (OR) rates at 3 months to BEAM and BEAMF regimens before ASCT plus CD19/22 CART therapy were 71.8% and 94.7%, respectively (P = 0.093). The BEAMF regimen showed a trend towards a superior duration of response compared with the BEAM regimen (P = 0.09). After a median follow-up of 28 months (range: 0.93-51.9 months), the BEAMF regimen demonstrated superior 2-year progression-free survival (PFS) (89.5% versus 63.9%; P = 0.048) and 2-year overall survival (OS) (100% vs 77.3%; P = 0.035) compared with the BEAM regimen. In the multivariable Cox regression analysis, OR at month 3 (responders) was remarkably correlated with better OS (hazard ratio: 0.112, P = 0.005) compared with OR (non-responders).

For patients with R/R B-NHL, the BEAMF regimen before ASCT plus CD19/22 CART therapy was correlated with superior PFS and OS than the BEAM regimen, and the BEAMF regimen is a promising alternative conditioning regimen for ASCT plus CAR-T therapy.

论文信息

作者
Xin X、Lin L、Yang Y、Wang N、Wang J、Xu J、Wei J、Huang L
第一作者单位
Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.China
通讯作者单位
Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Immunotherapy Research Center for Hematologic Diseases of Hubei Province, Wuhan, Hubei, China. Electronic address: yczhang@tjh.tjmu.edu.cn.China
文献类型
非美国政府资助研究
期刊
Cytotherapy2024 May
原文标识
PubMed 38385909 · DOI 10.1016/j.jcyt.2024.01.012