Clinical Research Of Hematopoietic Stemcell Transplantation In The Treatment Of T Cell Lymphoma

Part? Clinical study of hematopoietic stem cell transplantation in110 patients with T-cell lymphomaObjective:To investigate the clinical efficacy and related factors of autologous hematopoietic stem cell transplantation(auto-HSCT)and allogeneic hematopoietic stem cell transplantation(allo-HSCT)in T-cell non-Hodgkin's lymphoma(T-NHL).Methods:Clinical data of 110 patients with T-NHL who received hematopoietic stem cell transplantation between January 2006 and August 2016 at the First Affiliated Hospital of Soochow University were collected and analyzed retrospectively to explorethe efficacy of different transplantation methods in T-NHL and related factors affecting the efficacy of transplantation.Results:(1)110 T-NHL patients,70 males and 40 females,aged 7-64 years(median age 26 years).Disease subtypes:35 cases of T-cell lymphoblastic lymphoma(T-LBL),23 cases of NK/T cell lymphoma(NK/TCL),24 cases of peripheral T-cell lymphoma(PTCL,NOS),24 cases of variable large cell lymphoma(ALCL),3 cases of subcutaneous panniculitic T cell lymphoma(SPTCL)and 1 case of hepatosplenic T cell lymphoma(HSTCL).Transplantation type:56 cases of autologous hematopoietic stem cell transplantation(auto-HSCT),54 cases of allogeneic hematopoietic stem cell transplantation(allo-HSCT).(2)Themedian follow-up time was 34.5 months.56/110 patients with auto-HSCT,3 year overall survival(OS)and disease-free survival(EFS)were 76.5%and 60.9%,respectively.54/110 patients with allo-HSCT,3 year EFS and OS of allo-HSCT were 61.7%and 58.9%,respectively.There was no significant difference in OS and EFS between the two groups(P=0.287,P=0.522)(3)36/56 patients with CR1 status before auto-HSCT,3 yearOS and EFS were 86.5%and 75.6%respectively.20/56 patients with non-CRl status before auto-HSCT,3 year OS and EFS were 63.2%and 45.1%.The OS and EFS of the two groups were significantly different(P=0.048,P=0.039).(4)28/54 patients with CR1 status before allo-HSCT,3 yearOS and EFS were 79.3%and 76.2%respectively.26/54 patients with non-CR1 status before allo-HSCT,3 year OS and EFS were 52.0%and 48.7%.The OS and EFS of the two groups were significantly different(P=0.031,P=0.034).(5)36/110 cases were young and high-risk patients(age<40 years,IPI score ?3).20/54 cases treated with allo-HSCT,the 3 year OS and EFS were 74.8%and 73.9%.16/56 cases treated with auto-HSCT,the 3 year OS and EFS were 50.0%and 44.4%.The OS and EFS of the two groups were significantly different(P=0.042,P =0.018).Conclusion:HSCT can improve the efficacy of T cell lymphoma.Auto-HSCT in first complete remission(CR1)enables T-NHL patients with greater benefit.Allo-HSCT can cure some T-NHL patients,which can be considered for the treatment of young and high-risk T-NHL patients.Part? The different conditioning regimens in T-cell lymphomatreated with autologous hematopoietic stem celltransplantation:A multicenter studyObjective:To explore the efficacy and safety of different conditioningregimens in autologous hematopoietic stem cell transplantation(auto-HSCT)for T-cell lymphoma(T-NHL).Methods:The clinical data of 148 T-NHL patients who underwent auto-HSCT between August 2001 and December 2016 in Department of Hematology,First Affiliated Hospital of Soochow University and Department of Lymphoma,Peking University Cancer Hospital were retrospectively analyzed.We investigated the effect of different conditioning regimens on the survival of patients and analyzed the related adverse factors.Results:(1)Of the 148 patients,105 were males and 43 were females.The median age was 31 years(range,9-64 years).According to different conditioning regimens,there were 75 cases of BEAM group,27 cases of BEAC group,and 46 cases of CBV group.(2)The median follow-up time was 41 months.The estimated 5-year OS of BEAM,BEAC,and CBV were 81.0%,77.8%,and 62.7%,respectively.The estimated 5-year EFS was 62.2%,62.4%,and 59.4%.There was no significant difference in OS and EFS between the three groups(P=0.072,P=0.448).(3)The five-year CIR between BEAM,BEAC,and CBV was 33.3%,33.8%,and 43.1%,respectively;the five-year NRM was 3.5%,12.5%,and 6.4%,respectively,and there was no significant statistical difference between CIR and NRM in each group(P=0.497,P=0.239).(4)The incidence of grade 2 or higher mucositis and diarrhea in the BEAM group was significantly higher than that in the CBV group(53.7%vs 28.5%,P=0.012;36.1%vs 15.8%,P = 0.006),but not statistically significant compared with the BEAC group.(53.7%vs 39.6%,P=0.577;36.1%vs 24.5%,P=0.480).Conclusion:All three conditioning regimens are safe and effective choices for auto-HSCT in T-cell lymphoma.BEAM regimen has a better survival than BEAC and CBV.However,there is no statistically significant difference.The mucosa-related toxicity of BEAM regimen is worth attention.