皮肤T细胞淋巴瘤中血造干细胞移植:一个多中心倾向性比分匹配研究
Lía Bejarano1,2, Mercè Grau-Pérez3, Marina Paíno-Román1
1Dermatology Department, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain.
概括
造血干细胞移植 (HSCT) 并没有改善西班牙晚期皮肤T细胞淋巴瘤 (CTCL) 患者的生存率. 许多患者先前接受了广泛的治疗,这可能会影响HSCT的结果.
科学领域:
- 在瘤学瘤学.
- 皮肤病学 皮肤病学
- 血液学 血液学 血液学
背景情况:
- 先进的皮肤T细胞淋巴瘤 (CTCL) 是罕见的,侵略性的,并且往往不耐治疗.
- 造血干细胞移植 (HSCT) 是对耐火性CTCL的潜在治疗选择,但具有风险和有限的证据.
- 现有的关于CTCL的HSCT数据主要来自小型案例系列.
研究的目的:
- 为了评估西班牙高级初级CTCL患者的HSCT结果.
- 为了在现实世界中比较HSCT接受者与非接受者的生存率.
主要方法:
- 使用西班牙初级皮肤淋巴瘤注册表 (RELCP) 进行的回顾性观察研究.
- 倾向性得分匹配 (PSM) 以基于诊断,阶段和年龄平衡HSCT和非HSCT组.
- 使用考克斯回归进行的生存分析.
主要成果:
- 在2848名患者中,有51名患者接受了HSCT,其中70.6%的患者实现了完全反应.
- 56.9%的HSCT患者复发;39.2%的患者死亡,主要是由于疾病进展或HSCT并发症 (GVHD,败血症).
- 五年整体存活率 (OS) 为HSCT患者的58.9%,与非HSCT患者相比,没有显著的OS差异.
结论:
- 在这个高级CTCL队列中,没有观察到HSCT与非HSCT的生存益处.
- 之前的广泛治疗 (平均6.3行) 可能影响了HSCT的疗效.
- 需要进一步的研究来确定可能受益于HSCT的特定患者亚组.
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