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高剂量化疗和自身干细胞移植,用于复发或耐药的初级中大B细胞淋巴瘤

Hanan Alkhaldi¹, Alec Reinhardt², Melissa Barnett¹

¹Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas.

Transplantation and cellular therapy

|August 22, 2023

概括

高剂量化疗与自身干细胞移植 (HDC/ASCT) 显示在复发或耐药的初级中间体大B细胞淋巴瘤 (PMBCL) 中具有有效性. 接受Rituximab-vorinostat/gemcitabine/busulfan/melphalan (R-vorinostat/GemBuMel) 的患者的整体存活率有所改善.

科学领域:

血液学血液学血液学
在瘤学瘤学.
免疫治疗是一种免疫疗法.

背景情况:

原发性中性大B细胞淋巴瘤 (PMBCL) 是一种侵略性的非霍奇金淋巴瘤.
复发或耐药 (R/R) PMBCL 曾经接受过救援化疗和高剂量化疗 (HDC) 与自身干细胞移植 (ASCT) 的治疗.

研究的目的:

评估HDC/ASCT在R/RPMBCL患者的疗效.
为了比较不同调节方案之间的结果.

主要方法:

在2000-2022年期间,对60名R/R PMBCL患者进行了HDC/ASCT治疗的回顾性分析.
患者接受了Rituximab-BEAM或Rituximab-gemcitabine/busulfan/melphalan (R-GemBuMel) 配合或不配合沃里诺斯塔特,随后进行ASCT.
46名患者接受了中静脉辐射疗法 (RT).

主要成果:

整个队列的五年无进展生存率 (PFS) 和整体生存率 (OS) 分别为58%和77%.
在R-BEAM组:5年PFS51%,OS65%.
在R-vorinostat/GemBuMel组:5年PFS为69%,OS为82%.
在ASCT的负PET扫描和单个器官参与独立预测了改善的PFS.
R-vorinostat/GemBuMel独立地预测了改善的操作系统.

结论:

HDC/ASCT是R/R PMBCL的有效治疗方法.
与R-BEAM相比,R-vorinostat/GemBuMel疗法显示出更好的结果.
阴性PET扫描和有限的器官参与是有利的预后因素.

关键词:

自主干细胞移植自主干细胞移植高剂量化疗的高剂量化疗.主要的中间体大B细胞淋巴瘤.

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