几乎没有证据表明自体干细胞移植（ASCT）可以作为外周 T 细胞淋巴瘤（PTCL）患者诱导缓解后的巩固治疗。在这项研究中，我们对 PTCL 患者的巩固治疗和观察的真实世界生存结果进行了比较分析。 共有 92 名华东医院血液科收治的外周 T 细胞淋巴瘤 (PTCL) 患者复旦大学附属2013年1月至2019年4月根据是否接受大剂量治疗（HDT）并随后进行自体造血干细胞移植（ASCT）分为两组：ASCT巩固治疗（n=30）和观察（n=62）。分析两组之间的临床特征、治疗模式和生存结果。还进行单因素和Cox多因素回归分析来检测生存的预后因素。中位随访时间为41个月，接受ASCT治疗的外周T细胞淋巴瘤患者的中位总生存期（OS）尚未达到；中位无进展生存期（PFS）为77.0个月，远高于未进行ASCT的患者（OS p<0.003，PFS p=0.015）。亚组分析发现，高风险患者从 ASCT 中获益更多。合并噬血细胞性淋巴组织细胞增多症 (HLH) (p<0.001)、临床分期超过 III (p=0.014)、IPI 评分高于 3 (p=0.049) 和骨髓受累 (p=0.010) 是显着相关的独立预后因素操作系统和 PFS 更差。此外，含聚乙二醇化脂质体阿霉素（PLD）的化疗方案可以为接受ASCT的PTCL患者带来更高的总体缓解率（ORR）并延长生存期。ASCT作为巩固治疗后可以改善PTCL患者的长期生存率。实现诱导治疗的完全或部分缓解，特别是对于高风险患者。含有聚乙二醇化脂质体阿霉素的化疗方案可能比传统阿霉素在 PTCL 中诱导更深的缓解。确定最有可能从前期 ASCT 中受益的特定群体至关重要。版权所有 © 2024 Fulati、Ma、Wu、Qian、Chen、Hu、Chen、Xu、Huang、Zhang、Xie 和 Shen。

There was little evidence of autologous stem cell transplantation (ASCT) as consolidation therapy after remission of induction for patients with Peripheral T-cell lymphoma (PTCL). In this study, we conducted a comparative analysis of real-world survival outcomes between consolidation therapy and observation in patients with PTCL.A total of 92 patients with peripheral T-cell lymphoma (PTCL) who were admitted to the Department of Hematology, Huadong Hospital Affiliated with Fudan University from January 2013 to April 2019 were divided into two groups based on whether they were treated with high-dose therapy (HDT) followed by autologous hematopoietic stem cell transplantation (ASCT): ASCT as consolidation therapy (n=30) and observation (n=62). Clinical characteristics, treatment patterns, and survival outcomes were analyzed between the two groups. Univariate and Cox multivariate regression analyses were also performed to detect prognostic factors of survival.With a median follow-up time of 41 months, the median overall survival (OS) of peripheral T-cell lymphoma patients treated with ASCT was not reached; the median progression-free survival (PFS) was 77.0 months, which was much higher than that of patients without ASCT (p<0.003 for OS, p=0.015 for PFS). Subgroup analysis found that patients with high risks benefited more from ASCT. Combination with hemophagocytic lymphohistiocytosis (HLH) (p<0.001), clinical stage more than III (p=0.014), IPI score above 3 (p=0.049), and bone marrow involvement (p=0.010) were the independent prognostic factors significantly associated with worse OS and PFS. Additionally, pegylated liposomal doxorubicin (PLD)-containing chemotherapy regimen could bring a higher overall response rate (ORR) and prolong the survival of patients with PTCL who underwent ASCT.ASCT may improve the long-term survival of patients with PTCL as consolidation therapy after achieving complete or partial remission of induction treatment, particularly for those with high risks. The chemotherapy regimen containing pegylated liposomal doxorubicin may induce deeper remission than traditional doxorubicin in PTCL. It is crucial to identify the specific groups most likely to benefit from upfront ASCT.Copyright © 2024 Fulati, Ma, Wu, Qian, Chen, Hu, Chen, Xu, Huang, Zhang, Xie and Shen.