【科技前瞻】Cancer：自体干细胞移植显著延长淋巴瘤患者生存期！

生物_医药_科研 2019-10-14

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最近，研究人员发现自体干细胞移植（Autologous stem cell transplantation，ASCT）对一些处于首次完全缓解期（first complete remission，CR1）的淋巴结周围T细胞淋巴瘤（peripheral T-cell lymphoma，PTCL）患者有治疗益处。相关研究结果发表在Cancer杂志上。

来自北卡罗来纳州夏洛特市莱文癌症研究所研究人员分析了来自213名达到CR1的PTCL病人，其中119人患有淋巴结周围T细胞淋巴瘤。其中83人没有接受ASCT治疗，36人在CR1期间接受了巩固性的ASCT治疗。在随访的2.8年中，研究人员发现接受了ASCT治疗的病人并没有达到他们的中位总生存期，而没有接受ASCT治疗的病人的中位总生存期为57.6个月（P = 0.06）。对于患有晚期恶性疾病或者中到高的国际预后指数得分的病人，超长的生存期与ASCT治疗存在联系。与未接受ASCT治疗的患者相比，接受ASCT治疗的血管免疫母细胞性T细胞淋巴瘤患者（而非其他PTCL亚型的患者）的总生存期和无进展生存期显著延长。在多变量分析中，研究人员发现ASCT治疗与总生存期延长独立相关（危害比为0.37）。该研究的作者表示，这些结果具有很大的临床意义，对ASCT治疗淋巴结周围T细胞淋巴瘤具有指导意义。

推荐阅读原文：

The role of autologous stem cell transplantation in patients with nodal peripheral T-cell lymphomas in first complete remission: Report from COMPLETE, a prospective, multicenter cohort study.

Background: The role of autologous stem cell transplantation (ASCT) in the first complete remission (CR1) of peripheral T-cell lymphomas (PTCLs) is not well defined. This study analyzed the impact of ASCT on the clinical outcomes of patients with newly diagnosed PTCL in CR1. Methods: Patients with newly diagnosed, histologically confirmed, aggressive PTCL were prospectively enrolled into the Comprehensive Oncology Measures for Peripheral T-Cell Lymphoma Treatment (COMPLETE) study, and those in CR1 were included in this analysis. Results: Two hundred thirteen patients with PTCL achieved CR1, and 119 patients with nodal PTCL, defined as anaplastic lymphoma kinase–negative anaplastic large cell lymphoma, angioimmunoblastic T-cell lymphoma (AITL), or PTCL not otherwise specified, were identified. Eighty-three patients did not undergo ASCT, whereas 36 underwent consolidative ASCT in CR1. At the median follow-up of 2.8 years, the median overall survival was not reached for the entire cohort of patients who underwent ASCT, whereas it was 57.6 months for those not receiving ASCT (P = .06). ASCT was associated with superior survival for patients with advanced-stage disease or intermediate to high International Prognostic Index scores. ASCT significantly improved overall and progression-free survival for patients with AITL but not for patients with other PTCL subtypes. In a multivariable analysis, ASCT was independently associated with improved survival (hazard ratio, 0.37; 95% confidence interval, 0.15-0.89). Conclusions: This is the first large prospective cohort study directly comparing the survival outcomes of patients with nodal PTCL in CR1 with or without consolidative ASCT. ASCT may provide a benefit in specific clinical scenarios, but the broader applicability of this strategy should be determined in prospective, randomized trials. These results provide a platform for designing future studies of previously untreated PTCL.