摘要
目的探讨自体造血干细胞移植(auto-HSCT)和异基因造血干细胞移植(allo-HSCT)治疗自然杀伤/T细胞淋巴瘤(NKTL)患者的疗效及预后差异。方法选择2007年6月至2017年6月,于国内8家三级甲等教学医院住院并接受auto-HSCT或allo-HSCT治疗的37例NKTL患者为研究对象。根据患者接受的造血干细胞移植(HSCT)类型,将其分为auto-HSCT组(n=17)和allo-HSCT组(n=20)。auto-HSCT和allo-HSCT组患者的中位年龄分别为34.0岁(27.5~43.5岁)和33.0岁(25.8~41.3岁);男性患者分别为10和17例;女性分别为7和3例。采用回顾性队列研究方法,收集2组患者的临床病例资料,并且分析其疗效及预后。对2组患者的随访截至2017年12月31日。2组NKTL患者的临床分期、受累部位及移植前化疗方案种类构成比等计数资料比较,采用χ^(2)检验或Fisher确切概率法;对于呈偏态分布的计量资料,如患者年龄、单个核细胞(MNC)及CD34+细胞输注量等,2组比较采用Mann-Whitney U检验。采用Kaplan-Meier法绘制2组NKTL患者的累积复发、累积移植相关死亡率(TRM)、总体生存(OS)和疾病无进展生存(PFS)曲线,并且对2组上述指标采用log-rank检验进行比较。采用Cox比例风险回归模型,对NKTL患者OS率的影响因素进行单因素和多因素分析。本研究遵循的程序符合2013年修订版《世界医学协会赫尔辛基宣言》要求,并且与所有受试者签署临床研究知情同意书。结果①auto-HSCT组17例NKTL患者中,移植前处于完全缓解(CR)、部分缓解(PR)、疾病稳定(SD)和疾病进展(PD)的患者分别为12、4、1例及0;allo-HSCT组分别为4、11、1及4例。2组患者骨髓受累、移植前疾病状态、预处理方案种类的构成比分别比较,差异均有统计学意义(P=0.001,χ^(2)=12.087、P=0.016,χ^(2)=23.632、P<0.001)。②auto-HSCT组NKTL患者的中性粒细胞和血小板均植入成功,中位植入时间分别为11.0 d(9.5~11.0 d)和11.0 d(9.5~14.0 d);allo-HSCT组患者中,中性�
Objective To explore difference of clinical effects and prognosis of autologous hematopoietic stem cell transplantation(auto-HSCT)and allogeneic hematopoietic stem cell transplantation(allo-HSCT)in treatment of patients with natural killer/T cell lymphoma(NKTL).Methods From June 2007 and June 2017,a total of 37 patients underwent auto-HSCT or allo-HSCT from 8 Chinese GradeⅢclass A teaching hospitals were selected as research subjects.The median ages of patients in auto-HSCT group and allo-HSCT group were 34.0 years(27.5-43.5 years)and 33.0 years(25.8-41.3 years),respectively.There were 10 male and 7 female patients in auto-HSCT group,and 17 male and 3 female patients in allo-HSCT group,respectively.According to hematopoietic stem cell transplantation(HSCT)types of patients underwent,all subjects were divided into auto-HSCT group(n=17)and allo-HSCT group(n=20).Then clinical data of NKTL patients in auto-HSCT group and allo-HSCT group were collected,and clinical effect and prognosis of patients in two groups were analyzed by retrospectively cohort method.Patients in both groups were followed up until December 31,2017.Chi-square test or Fisher probabilities were used to compare categorical data between two groups,including composition ratios of clinical stages,marrow metastases,types of chemotherapy regimen and so on.Mann-Whitney U test was used to compare measurement data with skewed distribution,including age,transfusion amount of mononuclear cells(MNC)and CD34+cells etc..Kaplan-Meier method was used to draw survival curve of cumulative relapse,cumulative transplant-related mortality(TRM),overall survival(OS)and progression-free survival(PFS)of two groups,which were compared by log-rank test.Cox proportional hazards regression model was performed for univariate and multivariate analysis of OS rates between two groups.This study was in line with World Medical Association Declaration of Helsinki revised in 2013,and informed contents were obtained from all subjects.Results①In auto-HSCT group,there were 12,4,1 and
作者
方姝
王昭
付晓瑞
李乃农
胡亮钉
刘耀
董玉君
吴晓雄
王旖旎
张明智
李晓帆
李欲航
王买红
任汉云
吴亚妹
高春记
刘代红
黄文荣
Fang Shu;Wang Zhao;Fu Xiaorui;Li Nainong;Hu Liangding;Liu Yao;Dong Yujun;Wu Xiaoxiong;Wang Yini;Zhang Mingzhi;Li Xiaofan;Li Yuhang;Wang Maihong;Ren Hanyun;Wu Yamei;Gao Chunji;Liu Daihong;Huang Wenrong(School of Medicine,Nankai University,Tianjin 30071;Department of Hematology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Oncology,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China;Department of Hematology,Fujian Medical University Union Hospital,Fuzhou 350001,Fujian Province,China;Center of Hematopoietic Transplantation,Fifth Medical Center of PLA General Hospital,Beijing 100039,China;Center of Hematology,Xinqiao Hospital,Army Medical University,Chongqing 400037,China;Department of Hematology,Peking University First Hospital,Beijing 100034,China;Department of Hematology,Fourth Medical Center of PLA General Hospital,Beijing 100048,China;Department of Hematology,Fifth Medical Center of PLA General Hospital,Beijing 100071,China)
出处
《国际输血及血液学杂志》
CAS
2021年第5期406-414,共9页
International Journal of Blood Transfusion and Hematology
基金
北京市自然科学基金(7202185)。
关键词
淋巴瘤
造血干细胞移植
移植物抗宿主病
治疗结果
预后
回顾性研究
多中心研究
自然杀伤/T细胞淋巴瘤
Lymphoma
Hematopoietic stem cell transplantation
Graft vs host disease
Treatment outcome
Prognosis
Retrospective studies
Multicenter study
Natural killer/T cell lymphoma
