文章：

65岁及以上老年非霍奇金淋巴瘤患者的异基因移植：时间趋势分析

Allogeneic transplantation in elderly patients ≥65 years with non-Hodgkin lymphoma: a time-trend analysis

原文发布日期：2019-12-03

DOI: 10.1038/s41408-019-0261-1

类型: Article

开放获取: 是

英文摘要：

Allogeneic hematopoietic cell transplantation (allo-HCT) is a curative therapy for relapsed/refractory and high-risk non-Hodgkin lymphoma (NHL). However, no large studies have evaluated allo-HCT utilization in elderly NHL patients (≥65 years). Using the CIBMTR registry, we report a time-trend analysis of 727 NHL patients (≥65 years) undergoing the first allo-HCT from 2000 to 2015 in the United States (US). Study cohorts were divided by time period: 2000–2005 (N = 76) vs. 2006–2010 (N = 238) vs. 2011–2015 (N = 413). Primary outcome was overall survival (OS). Secondary outcomes included progression-free survival (PFS), relapse/progression (R/P), and non-relapse mortality (NRM). Median age at transplant, use of reduced-intensity conditioning, and graft source remained stable, while use of unrelated donors increased in the most current era. The 1-year probabilities of NRM from 2000 to 2005 vs. 2006–2010 vs. 2011–2015 were 24% vs. 19% vs. 21%, respectively (p = 0.67). Four-year probability of R/P was similar among the three cohorts: 48% (2000–2005), 40% (2006–2010), and 40% (2011–2015) (p = 0.39). The 4-year probabilities of PFS and OS (2000–2005 vs. 2006–2010 vs. 2011–2015) showed significantly improved outcomes in more recent time periods: 17% vs. 31% vs. 30% (p = 0.02) and 21% vs. 42% vs. 44% (p < 0.001), respectively. Utilization of allo-HCT increased in elderly NHL patients in the US since 2000 with improving survival outcomes.

摘要翻译： 

异基因造血细胞移植（allo-HCT）是治疗复发/难治性和高危非霍奇金淋巴瘤（NHL）的有效疗法。然而，目前尚无大规模研究评估老年NHL患者（≥65岁）中allo-HCT的应用情况。通过使用CIBMTR注册登记库，我们对2000年至2015年美国727例接受首次allo-HCT的老年NHL患者（≥65岁）进行了时间趋势分析。研究队列按时间段划分：2000-2005年（76例）对比2006-2010年（238例）对比2011-2015年（413例）。主要结局是总生存期（OS），次要结局包括无进展生存期（PFS）、复发/进展（R/P）和非复发死亡率（NRM）。移植时的中位年龄、降低强度预处理方案的使用及移植物来源保持稳定，而在最近时期，无关供者的使用有所增加。2000-2005年、2006-2010年和2011-2015年的1年NRM概率分别为24% vs. 19% vs. 21%（p=0.67）。三个队列的4年R/P概率相似：48%（2000-2005）、40%（2006-2010）和40%（2011-2015）（p=0.39）。4年PFS和OS概率（2000-2005 vs. 2006-2010 vs. 2011-2015）显示近期时段结局显著改善：PFS为17% vs. 31% vs. 30%（p=0.02），OS为21% vs. 42% vs. 44%（p<0.001）。自2000年以来，美国老年NHL患者中allo-HCT的应用增加，且生存结局不断改善。

原文链接：

Allogeneic transplantation in elderly patients ≥65 years with non-Hodgkin lymphoma: a time-trend analysis