Clinical Analysis Of Hematopoietic Stem Cell Transplantation In The Treatment Of74Patients With Malignant Lymphoma

[Objective] To evaluate the effect of hematopoietic stem cell transplantation in the treatment of patients with malignant lymphoma, and explore the prognosis factors of the patients undergoing lymphoma transplantation.[Method]74cases of patients with lymphoma, including66cases of non-Hodgkin’s lymphoma (NHL), which has33cases of B-cell and33cases of T/NK cell;48cases of NHL accept autologous hematopoietic stem cell transplantation, while18cases of allogeneic hematopoietic stem cell transplantation.8patients with Hodgkin’s lymphoma, which all accept autologous hematopoietic stem cell transplantation.74patients all underwent induction chemotherapy after diagnosis, the chemotherapy treatment before transplantation with a median of6(1to19) courses.48patients transplanted in CR status, the other26cases in PR/recurrence status.16cases were with TBI and58patients without TBI preconditioning.14cases of B-cell NHL preconditioning was plus rituximab, while19patients without the addition of rituximab. The study termination time is death or last follow-up.[Result]:The median follow-up time is16.5(1to68) months.The3-year overall survival (OS) and disease-free survival (DFS) were80.9%and70.4%. Multivariate analysis showed that NR/PR/recurrence status before transplantation, preconditioning with TBI, male gender are the adverse prognostic factors for lymphoma transplant patients. The3-year OS of patients achieved CR status PS PR/recurrence status before transplantation were89.3%PS61.2%,3-year DFS was77.6%PS53.3%, respectively. The3-year OS in patients with TBI and those without TBI preconditioning were67.5%PS84.7%. Patients without TBI preconditioning recurrence rate (15.5%) was significantly higher than TBI patients (6.3%) after transplantation, but the TRM (transplant-related mortality) of the TBI group (31.3%) was significantly higher than the non-TBI group(5.2%). Male gender was the adverse prognostic factor of lymphoma patients undergoing transplantation. Accepting more cycles of chemotherapy before transplantation may be the adverse prognostic factor (P=.077). Histological morphology and age had no statistically significant (P>.05).The3-year OS in patients with autologous transplantation and allogeneic transplantation were86%PS65.7%(P=.25),3-year DFS was80.6%PS38.9%(P=.08). High LDH values and IPI score>2are adverse prognostic factors, compared with normal LDH values and low IPI score(P=.03,P=.006, respectively); Patients with B-cell lymphoma, the survival in conditioning regimen with rituximab group and without rituximab group was92.9%and75.8%(P=.37), respectively.[Conclusion] Hematopoietic stem cell transplantation is an effective method for the treatment of malignant lymphoma. NR/PR/recurrence status before transplantation, preconditioning with TBI, male gender are the adverse prognostic factors for lymphoma transplant patients. The cycles of chemotherapy before transplantation may be the prognostic factor of the lymphoma patients undergoing transplantation. High LDH values and IPI score>2are adverse prognostic factors for NHL patients.