各种移植平台的比较结果，突出显示具有移植后的单倍型移植，用于成人T细胞白血病/淋巴瘤
Comparative outcomes of various transplantation platforms, highlighting haploidentical transplants with post-transplantation cyclophosphamide for adult T-cell leukaemia/lymphoma
影响因子:3.80000
分区:医学2区 / 血液学2区
发表日期:2025 Jan
作者:
Makoto Yoshimitsu, Takashi Tanaka, Nobuaki Nakano, Koji Kato, Hiroyuki Muranushi, Masahito Tokunaga, Ayumu Ito, Jun Ishikawa, Tetsuya Eto, Satoko Morishima, Toshiro Kawakita, Hidehiro Itonaga, Naoyuki Uchida, Masatsugu Tanaka, Keiichi Akizuki, Kenji Ishitsuka, Hiroyuki Ohigashi, Shuichi Ota, Toshihiko Ando, Yoshinobu Kanda, Takahiro Fukuda, Yoshiko Atsuta, Shigeo Fuji,
摘要
这项研究回顾性地比较了成人T细胞白血病/淋巴瘤患者的各种同种异体造血细胞移植（Allo-HCT）平台的结局。平台包括使用移植后环磷酰胺（PTCY），HLA匹配的相关供体（MRD），HLA匹配的无关捐赠者（MUD）和脐带血移植（CBT），包括人类白细胞抗原（HLA）与帕克洛尼斯相关的供体。包括在2016年至2021年间接受第一次Allo-HCT的患者。分析的结果是总生存期（OS），复发和非释放死亡率（NRM）。包括700名患者（PTCY，n = 121； MRD，n = 91； Mud，n = 160; CBT，n = 328）。幸存者的中位随访为794天，2年OS为48.1％（PTCY），48.8％（MRD），48.4％（泥）和34.6％（CBT）；复发的两年累积发生率为37.1％，47.5％，33.9％和45.1％，NRM的发生率为24.2％，19.8％，24.7％和27.3％。 PTCY与MRD和MUD相对于延迟血小板植入术有关。严重的急性或慢性移植物与宿主病的发生率没有增加。在PTCY组中，性能状态差是OS下方的重要预测指标，并且注入的CD34+细胞数量小于5×106/kg与延迟的中性粒细胞和血小板植入有关。这些结果表明，适用于PTCY的Allo-HCT是成人T细胞白血病/淋巴瘤患者的安全有效平台。
Abstract
This study retrospectively compared outcomes of various allogeneic haematopoietic cell transplantation (allo-HCT) platforms in patients with adult T-cell leukaemia/lymphoma. Platforms included human leukocyte antigen (HLA)-haploidentical-related donors using post-transplant cyclophosphamide (PTCY), HLA-matched related donors (MRD), HLA-matched unrelated donors (MUD) and cord blood transplantation (CBT). Patients who underwent their first allo-HCT between 2016 and 2021 were included. Outcomes analysed were overall survival (OS), relapse and non-relapse mortality (NRM). Seven hundred patients were included (PTCY, n = 121; MRD, n = 91; MUD, n = 160; CBT, n = 328). With a median follow-up of 794 days for survivors, 2-year OS was 48.1% (PTCY), 48.8% (MRD), 48.4% (MUD) and 34.6% (CBT); the respective 2-year cumulative incidence of relapse was 37.1%, 47.5%, 33.9% and 45.1% and that of NRM was 24.2%, 19.8%, 24.7% and 27.3%. PTCY was associated with delayed platelet engraftment relative to MRD and MUD. There was no increase in the incidence of severe acute or chronic graft-versus-host disease. In the PTCY group, poor performance status was a significant predictor of inferior OS, and infused CD34+ cell numbers of less than 5 × 106/kg were associated with delayed neutrophil and platelet engraftment. These results suggest that allo-HCT with PTCY is a safe and effective platform for patients with adult T-cell leukaemia/lymphoma.