Objective: To evaluate the clinical outcomes in patients with relapsed or refractory peripheral T-cell lymphoma (PTCL) who had undergone allogeneic hematological stem cell transplantation (allo-HSCT). Methods: From June 2007 to June 2017, the clinical data of PTCL patients who underwent HSCT from eight hospitals were assessed retrospectively. Results: There were 23 patients diagnosed as relapsed or refractory PTCL with chemoresistance who underwent allo-HSCT. Among these patients, 18 were identified as progressive disease (PD) status and 5 patients as stable disease (SD) status before allo-HSCT. Seventeen patients received allo-HSCT from matched sibling donor (MSD),2 patients from matched unrelated donor and 4 patients from related haplo-identical donor (HD). After a median follow-up of 29 months, 21 patients survived longer than 28 days after allo-HSCT. Hematopoietic reconstitution was achieved in 20 of the 21 patients. The median time of myeloid and platelet engraftment were+13 (9-22) d and+16(10-38) d, respectively. The 100-d treatment-related mortality rate was 13.1%. Acute GVHD occurred in 11(47.8%) patients at a median time of 22(6-82) d after transplantation. Grade Ⅱ~Ⅳ aGVHD occurred in 6 patients. Chronic GVHD occurred in 10 patients at a median of 7.9 (3.5-27) months. After a median follow-up of 29 months, 13 patients died after HSCT. Four of them died of complications associated with allo-HSCT, and other 9 patients died of the primary lymphoma. The 3-years cumulative overall survival (OS) and progress-free survival (PFS) were 43.03% (95%CI: 29.79-69.16) and 39.13% (95%CI: 23.50-65.14), respectively. No significant difference was found in the 3-year PFS between patients with PD status and SD status before allo-HSCT (P=0.133). Conclusion: Allo-HSCT can be a promising treatment for relapsed or refractory PTCL with chemoresistance.
目的： 分析异基因造血干细胞移植对化疗耐药的复发/难治外周T细胞淋巴瘤（PTCL）的疗效。 方法： 回顾性收集国内8所三甲教学医院2007至2017年行异基因造血干细胞移植治疗化疗耐药的复发/难治T细胞淋巴瘤患者临床资料，总结分析患者的临床特点及治疗转归。 结果： 共有23例对化疗耐药的复发/难治PTCL患者纳入本研究，其中18例移植前处于疾病进展状态，5例处于疾病稳定状态。23例患者中17例为同胞全合异基因造血干细胞移植，2例为无关供者造血干细胞移植，4例为单倍体异基因造血干细胞移植。存活大于28 d可评估植入的患者21例，其中20例获得稳定的粒系及血小板植入，白细胞中位植入时间为+13 d（9~22 d），血小板中位植入时间为+16 d（10~38 d）。100 d移植相关死亡率为13.1%。11例（47.8%）患者发生急性移植物抗宿主病（aGVHD），中位发生时间为+22 d（+6~82 d），6例为Ⅱ-Ⅳ度aGVHD。移植后存活大于100 d患者15例，其中10例患者发生慢性移植物抗宿主病，中位发生时间为7.9个月（3.5~27个月）。所有纳入研究的复发难治患者移植后中位随访时间29个月（0.3~102个月），13例（56.5%）死亡，中位死亡时间为116 d（21~240 d），其中4例死于移植相关并发症，9例死于疾病复发进展。3年总生存率为43.03%（95%CI：29.79~69.16）；3年无进展生存率39.13%（95%CI：23.50~65.14）。移植前疾病状态为疾病进展（PD）的患者与疾病稳定（SD）的患者移植后无进展生存率差异无统计学意义（P=0.113）。 结论： 异基因造血干细胞移植是治疗化疗耐药复发/难治外周T细胞淋巴瘤的有效手段。.
Keywords: Hematopoietic stem cell transplantation; Lymphoma, T-Cell; Recurrence; Salvage therapy.