This study aimed to identify the benefits of autologous-stem cell transplantation (auto-SCT) and allogeneic-SCT (allo-SCT) in patients with aggressive T-cell lymphomas to aid in the selection of transplantation type in clinical practice. This study retrospectively analyzed data from 598 patients who underwent transplantation for T-cell lymphomas from 2010 to 2020. In total, 317 patients underwent up-front SCT as consolidation therapy. The 3-year progression-free survival (PFS) and overall survival (OS) were 68.7% and 76.1%, respectively. Patients who underwent auto-SCT had significantly better OS (p = 0.026) than those who underwent allo-SCT; however, no statistical difference in PFS was found. Transplantation was used as a salvage therapy in 188 patients who had relapsed/refractory disease. Overall, 96 (51.1%) patients underwent auto-SCT and 92 (48.9%) patients underwent allo-SCT. Auto-SCT improved long-term survival in patients with complete remission (CR). Allo-SCT demonstrated better 3-year PFS in patients with partial remission and relapsed/refractory disease status. However, >50% of patients died within 1 year of allo-SCT. As a consolidative therapy, up-front auto-SCT demonstrated a survival benefit. Auto-SCT was also effective in patients who achieved CR after salvage therapy. If the disease persists or cannot be controlled, allo-SCT may be considered with reduced intensity conditioning.
本研究旨在明确自体干细胞移植(auto-SCT)与异基因干细胞移植(allo-SCT)在侵袭性T细胞淋巴瘤患者中的获益，以辅助临床实践中移植类型的选择。该研究回顾性分析了2010年至2020年间接受移植治疗的598例T细胞淋巴瘤患者数据。其中，317例患者接受了一线干细胞移植作为巩固治疗，其3年无进展生存率(PFS)和总生存率(OS)分别为68.7%和76.1%。接受auto-SCT的患者OS显著优于allo-SCT患者(p=0.026)，但两组PFS无统计学差异。另有188例复发/难治性疾病患者接受了移植作为挽救治疗，其中96例(51.1%)接受auto-SCT，92例(48.9%)接受allo-SCT。结果显示，auto-SCT可改善完全缓解(CR)患者的长期生存；而对于部分缓解及复发/难治状态的患者，allo-SCT显示出更好的3年PFS。但需注意，超过50%的allo-SCT患者在移植后1年内死亡。总体而言，作为巩固治疗时，一线auto-SCT具有生存获益；对于挽救治疗后达到CR的患者，auto-SCT同样有效。若疾病持续存在或难以控制，可考虑采用减低强度预处理的allo-SCT。
肿瘤(癌症)患者之家