Survival Analysis Of Patients With Malignant Lymphoma Treated By Autologous Hematopoietic Stem Cell Transplantation

Background:Malignant lymphoma(malignant lymphoma ML)is a kind of malignant hematopoietic tumors which originates from the lymph nodes and lymph node tissues,ML can be divided into two types: Hodgkin's lymphoma(HL)and non Hodgkin lymphoma(NHL)which accounts for about half of hematopoietic tumors,whose rate of incidence is increasing year by year.Several studies have found that conventional radiotherapy and chemotherapy for malignant lymphoma cannot improve patients' long-term survival,and autologous hematopoietic stem cell transplantation(ASCT)plays a very positive role in the treatment of malignant lymphoma,and it has become an important means for the treatment of high-risk refractory cases.ASCT includes several steps: 1)high-dose radiotherapy or chemotherapy for patients,transplanting autologous hematopoietic stem cell,and hematopoietic reconstruction,through which we will achieve the purpose of treating disease.High-dose chemotherapy combined with ASCT(HDT/ASCT)has become a standard treatment for relapsed and refractory invasive malignant lymphoma which can significantly reduce the recurrence rate and improve the survival rate.Current studies have demonstrated that several prognostic factors have a significant relationship with the prognosis of malignant lymphoma patients treated with ASCT and these factors include age,stage of disease,B symptoms,tumor size,gender,transplantation of state and salvage treatment programs.Objective:To explore the prognostic factors of ASCT for the treatment of malignant lymphoma.Methods:We collected about 110 patients with malignant lymphoma in our hospital who were treated with ASCT.And patients' clinical follow-up data include patients' clinical information,pre-transplant therapy,remission status,post-transplant treatment,and prognosis.These factors were retrospectively analyzed.SPSS statistical method was applied into the analysis of ASCT effects on the malignant lymphoma patients.Kaplan Meier survival analysis and Cox proportional hazard model analysis were also applied into this article.Results: 110 patients were followed up through out-patient or telephone.After follow-up period,8 cases were out of touch,23 patients were died and of which there are 21 patients were died from relapse,1 cases were died from acute liver failure dissociated with primary disease,1 cases were died from multiple organ failure syndrome patients secondary to severe pulmonary infection.3 years overall survival(OS)and progression free survival(PFS)after transplantation were separately 80.9% and 76.4% with the median survival time was 39.4 months.IPI score >2,evelated serum lactate dehydrogenises-(LDH),bone marrow infiltration and HBV infection are closely related to the overall survival of patients after transplantation(P<0.05).Besides,without complete remission state before transplantation(PR/NR/recurrent)(P=0.016)and,without maintenance therapy after transplantation(P=0.006)are independent negative prognostic factors for malignant lymphoma patients undergoing ASCT.Conclusion:ASCT can improve the long-term survival rate of malignant lymphoma patients.IPI score>2,elevated LDH,bone marrow infiltration and HBV infection are closely related to overall survival of lymphoma patients after transplantation.Besides,without complete remission state(PR/NR/recurrence)before transplantation and without maintaining treatment after transplantation are independent risk factors for malignant lymphoma patients after ASCT.