ASTCT 和 USCLC 针对蕈样肉芽肿和塞扎里综合征同种异体干细胞移植的临床实践建议。
ASTCT and USCLC Clinical Practice Recommendations for Allogeneic Stem Cell Transplant in Mycosis Fungoides and Sézary Syndrome.
发表日期：2024 Aug 31
作者：
Amrita Goyal, Daniel O'Leary, Bouthaina Dabaja, Wen-Kai Weng, Jasmine Zain, Corey Cutler, Joan Guitart, Youn H Kim, Larisa J Geskin, Richard T Hoppe, Lynn D Wilson, Anne W Beaven, Steve Horwitz, Pamela B Allen, Stefan K Barta, Kimberly Bohjanen, Jonathan E Brammer, Joi B Carter, Nneka Comfere, Jennifer A DeSimone, Kathryn Dusenbery, Madeleine Duvic, Auris Huen, Deepa Jagadeesh, Chris R Kelsey, Michael S Khodadoust, Mary Jo Lechowicz, Neha Mehta-Shah, Alison J Moskowitz, Elise A Olsen, Christina Poh, Barbara Pro, Christiane Querfeld, Craig Sauter, Lubomir Sokol, Olayemi Sokumbi, Ryan A Wilcox, John A Zic, Mehdi Hamadani, Francine Foss
来源：
Stem Cell Research & Therapy
摘要：
蕈样肉芽肿 (MF) 和塞扎里综合征 (SS) 是皮肤 T 细胞淋巴瘤 (CTCL) 最常见的亚型。虽然 MF 通常呈惰性病程，但一部分患者会出现进行性和/或难治性疾病。 Sézary 综合征是一种侵袭性 CTCL，与继发于免疫损害和机会性感染的高发病率和死亡率相关。尽管同种异体造血细胞移植 (allo-HCT) 是目前唯一可用的 MF/SS 潜在治愈性治疗方式，并且已包含在 NCCN 和 ASTCT 治疗指南中，但尚未发布关于转诊标准、时机和异体 HCT 方法的指南来帮助指导临床医生护理这些患者。对皮肤科 (n=9)、移植血液学/肿瘤学 (n=10)、非移植血液学/肿瘤学 (n=8) 和放射肿瘤学 (n=5) 的 32 名专家进行德尔菲调查来自美国各地。共识需要 ≥75% 的参与者达成一致。针对四个主题生成了 16 份共识声明：1) 考虑进行异基因 HCT 的转诊标准，2) 异基因 HCT 准备方案和程序 3) 异基因 HCT 时的疾病状态HCT，以及 4) 移植前和移植后的多学科管理。这些临床实践指南为 MF/SS 的异基因 HCT 决策提供了框架，并强调了未来前瞻性研究的领域。版权所有 © 2024。出版者爱思唯尔公司
Mycosis fungoides (MF) and Sézary syndrome (SS) are the most common subtypes of cutaneous T-cell lymphoma (CTCL). While MF generally follows an indolent course, a subset of patients will experience progressive and/or treatment-refractory disease. Sézary syndrome is an aggressive CTCL associated with high morbidity and mortality secondary to immune compromise and opportunistic infection. Although allogeneic hematopoietic cell transplant (allo-HCT) is currently the only available potentially curative treatment modality for MF/SS and is included in NCCN and ASTCT treatment guidelines, there is no published guidance regarding referral criteria, timing and allo-HCT approach to help guide clinicians caring for these patients.Delphi survey of 32 specialists in dermatology (n=9), transplant hematology/oncology (n=10), non-transplant hematology/oncology (n=8), and radiation oncology (n=5) from across the United States. Consensus required agreement of ≥75% of participants.Sixteen consensus statements were generated on four topics: 1) criteria for referral for consideration for allo-HCT, 2) allo-HCT preparative regimens and procedures 3) disease status at the time of allo-HCT, and 4) multidisciplinary management in the pre- and post-transplant settings.These clinical practice guidelines provide a framework for decision-making regarding allo-HCT for MF/SS and highlight areas for future prospective investigation.Copyright © 2024. Published by Elsevier Inc.