文章：

基于PTCY的单倍体相合供者移植与HLA匹配相关及无关供者移植在难治性或复发性淋巴瘤患者中的比较——一项配对分析

PTCY-Based Haploidentical Donor Transplantation versus HLA-Matched Related and Unrelated Donor Transplantations in Patients with Refractory or Relapsed Lymphoma—A Matched-Pair Analysis

原文发布日期：31 October 2023

DOI: 10.3390/cancers15215246

类型: Article

开放获取: 是

英文摘要：

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has demonstrated its potential as a curative option for patients with r/r lymphoma. With the introduction of post-transplant cyclophosphamide-based (PTCY) graft-versus-host disease (GvHD) prophylaxis, allo-HCT using haploidentical related donors (Haplo-HSCT) has emerged as a valuable alternative for patients without an available HLA-matched donor. In this study, we compared intermediate and long-term outcomes between Haplo-HSCT and HLA-matched related donor (MRD) and unrelated donor (URD) transplantations in 16 matched pairs using age, disease status, lymphoma classification and performance status as matching criteria. Of note, 88% of patients in each group presented with active disease at the time of conditioning. After a median follow-up of >10 years, 10-year overall and progression-free survival and non-relapse mortality incidence after Haplo-HSCT were 31%, 25% and 38%, respectively, and did not differ compared to the values observed in MRD-HSCT and URD-HSCT. A remarkable lower incidence of acute GvHD ≥ II and moderate and severe chronic GvHD was observed after Haplo-HSCT compared to MRD-HSCT (50%/50%,p =0.03/0.03) and URD-HSCT (44%/38%,p =0.04/0.08), resulting in slightly higher 10-year GvHD-free and relapse-free survival (25%) and chronic GvHD-free and relapse-free survival (25%) in the Haplo-HSCT group. In conclusion, Haplo-HSCT is an effective treatment in patients with non-remission NHL. Given its advantage of immediate availability, haploidentical donors should be preferably used in patients with progressive disease lacking an HLA-matched related donor.

摘要翻译： 

异基因造血干细胞移植（allo-HSCT）已显示出作为复发/难治性淋巴瘤患者治愈性治疗选择的潜力。随着基于移植后环磷酰胺（PTCY）的移植物抗宿主病（GvHD）预防方案的应用，对于缺乏人类白细胞抗原（HLA）全相合供者的患者，单倍体相合亲缘供者移植（Haplo-HSCT）已成为一种有价值的替代方案。本研究通过年龄、疾病状态、淋巴瘤分型及体能状态作为配对标准，在16对匹配病例中比较了Haplo-HSCT与HLA全相合亲缘供者（MRD）及非亲缘供者（URD）移植的中长期疗效。值得注意的是，各组中88%的患者在预处理时处于活动性疾病状态。中位随访时间超过10年后，Haplo-HSCT组的10年总生存率、无进展生存率及非复发死亡率分别为31%、25%和38%，与MRD-HSCT和URD-HSCT组相比无显著差异。与MRD-HSCT（50%/50%，p=0.03/0.03）和URD-HSCT（44%/38%，p=0.04/0.08）相比，Haplo-HSCT后≥II级急性GvHD及中重度慢性GvHD发生率显著降低，使得Haplo-HSCT组的10年无GvHD无复发生存率（25%）及无慢性GvHD无复发生存率（25%）略高。综上所述，Haplo-HSCT是非缓解状态非霍奇金淋巴瘤患者的有效治疗手段。鉴于其供者即时可得的优势，对于缺乏HLA全相合亲缘供者的疾病进展患者，应优先考虑使用单倍体相合供者。

原文链接：

PTCY-Based Haploidentical Donor Transplantation versus HLA-Matched Related and Unrelated Donor Transplantations in Patients with Refractory or Relapsed Lymphoma—A Matched-Pair Analysis