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Clinical study of Autologous Hematopoietic Stem Cell Transplantation in T cell lymphoblastic lymphomaObjectiveTo investigate the clinical efficacy and related factors of autologous hematopoietic stem cell transplantation(Auto-HSCT)in the treatment of T lymphoblastic lymphoma(T-LBL).Methods1.The clinical data of 41 T-LBL patients who underwent Allo-HSCT from April 2006 to July 2017 in the Department of Hematology,the First Affiliated Hospital of Soochow University and the Department of Lymphoma,Peking University Cancer Hospital were collected and analyzed retrospectively.2.(1)According to the pre-transplant disease status,patients were divided into the first complete remission state(CR1)group and the non-CR1 group.(2)According to the International Prognostic Index(IPI),patients were divided into low-intermediate risk group(IPI<3 scores)and high-intermediate risk group(IPI>3 scores).3.OS?PFS?CIR and NRM were compared with the log-rank test and plotted using the Kaplan-Meier method.Results1.Of the 41 patients,there were 30 males and 11 females with median age of 24 years(range:11-53 years).According to the Ann Arbor staging,33(80.5%)patients were in stage ?/?.Twelve(29.3%)patients have mediastinal masses,and 20(48.8%)of patients are bone marrow(BM)involvement.2.(1)There were 26(63.4%)patients who achieved CR1 before transplantation,and 15(36.6%)patients in the non-CRl group.(2)There were 29(70.7%)patients in the low-intermediate group and 12(34.1%)patients in the middle-high-risk group.3.With a median follow-up of 29 months,(1)The 3-year overall survival(OS)and progression-free survival(PFS)for 41 patients were 64.3%and 66.0%,respectively;-year cumulative recurrence rate(CIR)was 30.7%,and 3-year non-recurring mortality(NRM)was 4.8%.(2)The 3-year OS of the CR1 group and the non-CRl group were 83.4%and 38.9%(P=0.010),and the 3-year PFS of two groups were 83.8%and 40.0%(P=0.007),respectively;The 3-year CIR was 16.2%and 53.3%(P=0.015),and the 3-year NRM was 0%and 14.29%(P=0.157),respectively.The survival of patients in CR1 was significantly better than the non-CR1 group.(3)The 3-year OS of the IPI low-intermediate risk group and the high-intermediate risk group were 76.9%and 35.7%(P=0.014)and the 3-year PFS were 77.4%and 40.0%(P=0.011),respectively;The 3-year CIR were18.1%and 60.0%(P=0.007),and the 3-year NRM were 5.56%and 0%(P=0.683),respectively.The OS and PFS of patients with low-intermediate risk group were significantly higher than the other group.ConclusionAuto-HSCT could improve the survival of T-LBL,especially for patients with low-intermediate groups.Pre-transplant disease status and IPI score are important influencing factors on survival in patients with aggressive T-LBL treated by Auto-HSCT.Part ? Clinical study of Allogeneic Hematopoietic Stem Cell Transplantation in T cell lymphoblastic lymphomaObjectiveTo investigate the clinical efficacy and related factors of allogeneic hematopoietic stem cell transplantation(Allo-HSCT)in the treatment of T lymphoblastic lymphoma(T-LBL).Methods1.The clinical data of 42 T-LBL patients who underwent Allo-HSCT from August 2007 to July 2017 in the Department of Hematology,the First Affiliated Hospital of Soochow University and the Department of Lymphoma,Peking University Cancer Hospital were collected and analyzed retrospectively.2.(1)According to the pre-transplant disease status,patients were divided into the first complete remission state(CR1)group and the non-CR1 group.(2)According to different donor sources,patients were divided into haploidentical related donors HSCT group(Haplo-HSCT)and matched sibling donors HSCT group(Sib-HSCT).3.OS?PFS?CIR and NRM were compared with the log-rank test and plotted using the Kaplan-Meier method.Results1.Of the 42 patients,29 males and 13 females,median age 23 years(aged 11-47 years).Twenty-seven(64.3%)patients presented with International prognostic index(IPI)? 3 and 24(57.1%)patients have bone marrow involvement.2.(1)There were 26(61.9%)patients who reached CR1 before transplantation,and 16(38.1%)patients in the non-CR1 group.(2)All 42 patients underwent Allo-HSCT,including Haplo-HSCT 28(66.7%)cases and Sib-HSCT 14(33.3%)cases.3.With a median follow-up of 22.5(2-133)months,(1)The 3-year overall survival(OS)and progression-free survival(PFS)for 42 T-LBL patients were 58.1%and 60.9%,respectively;3-year cumulative recurrence rate(CIR)was 20.3%,and 3-year non-recurring mortality(NRM)was 23.5%.(2)The 3-year OS of the CR1 group and the non-CR1 group were 74.3%and 21.5%(P=0.036),and the 3-year PFS of two groups was 74.9%and 32.6%(P=0.043),respectively;The 3-year CIR were 15.3%and 25.3%(P=0.608),and the 3-year NRM were 11.5%and 56.1%(P=0.035),respectively.The CR1 group survived significantly better than the non-CR1 group.(3)The 3-year OS of the Haplo-HSCT group and the Sib-HSCT group were 60.2%and 53.6%,respectively(P=0.870);the 3-year PFS were 64.3%and 53.5%,respectively(P=0.853);The 3-year CIR were 5.56%and 38.8%(P=0.025),the 3-year NRM were 31.6%and 12.5%(P=0.149),respectively.There was no significant difference in survival between the two groups.ConclusionAllo-HSCT can improve the efficacy of T-LBL;Allo-HSCT in CR1 enables T-LBL patients with greater benefit.There was no significant difference in the long-term survival between Haplo-HSCT and Sib-HSCT,haplo-HSCT may be a considerable choice for young,high-risk T-LBL patients without matched sibling donors. |
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