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全身辐射与化学疗法相比,在复发性/反射性大B细胞淋巴瘤的自身造血干细胞移植中仅限于条件化治疗

M Ebadi¹, X Fan², G Schoch²

¹Department of Radiation Oncology, University of Washington and Radiation Oncology Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.

Clinical oncology (Royal College of Radiologists (Great Britain))

|October 31, 2025

概括

自主干细胞移植 (ASCT) 与全身辐射 (TBI) 条件显示出与仅化学疗法ASCT对大B细胞淋巴瘤 (LBCL) 患者的结果相似. 这项研究表明,TBI可能有助于克服在接受ASCT的LBCL患者的不良预后因素.

科学领域:

血液学血液学血液学
在瘤学瘤学.
移植医学移植医学

背景情况:

化学抗原受体T细胞 (CAR-T) 疗法正在进步,但对于缺乏CAR-T接入或晚期复发的大型B细胞淋巴瘤 (LBCL) 患者,自身干细胞移植 (ASCT) 仍然至关重要.
标准的ASCT调节通常仅涉及化疗.
根据LBCL的放射反应性,需要对ASCT基于全身辐射 (TBI) 调节的疗效进行调查.

研究的目的:

为了回顾评估基于TBI的调节是否会改善复发/耐药 (r/r) LBCL患者的ASCT结果,而不是仅使用化疗的调节.
在接受不同调节方案的患者中分析无进展生存率 (PFS) 和总生存率 (OS).
确定影响 r/r LBCL ASCT 结果的因素.

主要方法:

在2012-2021年期间接受ASCT的56名LBCL患者的回顾性分析.
患者被划分为TBI (n=19) 和仅化学疗法 (n=37) 调节组.
排除标准被应用以平衡群体之间的年龄,TBI组表现出更不利的预后特征.

主要成果:

创伤队列有更多的不良特征:更高的男性性别比例 (89.5%对62.2%),更早的复发 (≤12个月:52.6%对32.4%),以及更短的ASCT时间 (中位数11.7对21.8个月).
两年PFS为58% (TBI) 与67% (化疗),两年OS为79% (TBI) 与80% (化疗),两组之间没有显著差异.
在ASCT中 pozitron发射断层扫描 (PET) 的阳性是PFS失败的显著预测因素 (HR:6.97,P < 0.001),而调节疗法则不是.

结论:

尽管负面预后因素的负担更高,但基于TBI的调节在接受ASCT的r/rLBCL患者中产生了与仅化疗调节相比的PFS和OS.
这些发现表明,TBI可能在选定的LBCL患者中提供可比或潜在的补偿性益处.
需要进一步的前性研究来证实这些产生假设的结果.

关键词:

自主干细胞移植自主干细胞移植大型B细胞淋巴瘤整个身体的辐射辐射.

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