摘要
目的:探讨新药时代自体造血干细胞移植(autologous hematopoietic stem cell transplantation,ASCT)治疗复发或难治性(relapse or refractory,R/R)经典型霍奇金淋巴瘤(classical Hodgkin's lymphoma,cHL)的疗效.方法:回顾性分析 2010年 1月至 2022年 12月在中国医学科学院血液病医院诊治的 56例挽救治疗敏感、序贯ASCT治疗的R/R cHL患者,根据挽救治疗是否包含维布妥昔单抗(brentuximab vedotin,BV)或程序性死亡受体 1(programmed death-1,PD-1)抑制剂分为新药组 32例和非新药组 24例,分析两组患者的临床特征及疗效,使用Kaplan-Meier法进行生存分析.结果:56例患者中男性 35例,女性 21例,中位移植年龄 29(11～55)岁.中位随访时间 56(2～137)个月,移植后预期 5年总生存(overall survival,OS)率和无进展生存(progression-free survival,PFS)率分别为 94.3%和 75.8%.新药组患者的 5年PFS更优(90.1%vs.59.1%,HR=0.23,95%CI:0.07～0.71,P=0.011),但OS差异无统计学意义(93.5%vs.95.5%,HR=1.2,95%CI:0.14～10.34,P=0.873).结论:对于挽救治疗敏感的R/R cHL患者,ASCT仍然是标准的巩固治疗策略.新药在移植前、后的应用可进一步提高ASCT治疗R/R cHL患者的生存.
Abstract
Objective:Evaluating the efficacy and outcomes of autologous hematopoietic stem cell transplantation(ASCT)for patients with relapsed or refractory(R/R)classical Hodgkin's lymphoma(cHL)using novel agents.Methods:Fifty-six patients diagnosed with R/R cHL ex-hibiting sensitivity to salvage therapy underwent ASCT at the Institute of Hematology&Blood Diseases Hospital from January 2010 to December 2022 participated in our review.The patients were assigned into two groups based on whether they received brentuximab vedot-in(BV)or programmed death-1(PD-1)inhibitors pre-transplantation:the novel agent group(n=32)and no novel agent group(n=24).Their characteristics and outcomes were analyzed retrospectively,and survival was assessed using Kaplan-Meier method.Results:Median age of transplantation for 56 patients with R/R cHL was 29 years(range:11-55 years),with 35 male and 21 female patients.With a median follow-up of 56(2-137)months,the 5-year overall survival(OS)and progression-free survival(PFS)rates post-transplantation were estimated to be 94.3%and 75.8%,respectively.The 5-year PFS was superior for patients using novel agents pre-transplantation(90.1%vs.59.1%,hazard ra-tio[HR]=0.23,95%confidence intervals[CI]:0.07-0.71,P=0.011)without a statistically significant difference in OS(93.5%vs.95.5%,HR=1.2,95%CI:0.14-10.34,P=0.873).Conclusions:ASCT remains the standard consolidation therapy for patients with salvage-sensitive R/R cHL.The incorporation of novel agents pre-and post-transplantation enhances the outcomes of patients who have undergone ASCT for R/R cHL.
NETL
NSTL
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