Therapeutic effect of CY-fTBI and BMM conditioning regimen in the process of allo-HSCT treating Ⅲ,Ⅳ non-Hodgkin lymphoma: 15 years analysis of single-center.
- Author:
Ting SUN
1
;
Liangding HU
1
;
Min JIANG
1
;
Hongmei NING
1
;
Bin ZHANG
1
;
Jing REN
1
;
Yuhang LI
1
;
Botao LI
1
;
Jianlin CHEN
1
;
Fan YANG
1
;
Chen XU
1
;
Jun WANG
1
;
Xiao LOU
1
;
Jiangwei HU
1
;
Hu CHEN
1
Author Information
- Publication Type:Journal Article
- MeSH: Disease-Free Survival; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Lymphoma, Non-Hodgkin; therapy; Neoplasm Recurrence, Local; Retrospective Studies; Transplantation Conditioning; methods; Transplantation, Homologous
- From: Chinese Journal of Hematology 2015;36(10):830-834
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo investigate the efficacy of allogeneic hematopoietic stem cell transplantation(allo-HSCT)in the treatment of patients with Ⅲ,Ⅳ non-Hodgkin lymphoma(NHL), and compared the efficacy between Cy- fractionated to talbody irradiation(fTBI)based conditioning regimen and Maryland, horse flange and mitoxantrone(BMM).
METHODSThe clinical data of 47 patients with Ⅲ, Ⅳ NHL after allo- HSCT from November 1998 to May 2014 were collected and retrospectively analyzed. To observe the hematopoietic reconstruction recovery after transplantation, cumulative incidence of acute graft- versus- host- disease (aGVHD) and chronic graft- versus- host- disease (cGVHD), transplantation related mortality (TRM), recurrence rate (RR), disease- free survival (DFS), overall survival(OS). Compare the efficacy of fTBI and BMM conditioning regimen at the same time.
RESULTSNeutrophils achieving 0.5×10⁹/L and platelets achieving 50×10⁹/L on day 17 (range, 10- 72) post transplantation. Acute GVHD occurred in 53.19%, among them, grade Ⅰ-Ⅱ occurred in 42.55%, grade Ⅲ-Ⅳ occurred in 10.65%, and cGVHD occurred in 21.28%. 21 patients were alive with a median follow up of 9.7 months(0.2-149.1 months). Overall survival(OS)was 73.5%, 49.3%, 40.1% respectively in the first, third and fifth year in Cy-fTBI group; in BMM group it was 67.8%, 32.9% and 31.4% respectively, and disease-free survival(DFS)was 65.3%, 45.6%, 30.2% respectively in the first, third and fifth year. In Cy-fTBI group, the recurrence rate(RR)and transplantation related mortality(TRM)in the first year were 18.9%, 23.0% respectively, the third year were 19.5%, 38.3% and the fifth year were 35.2%, 39.2%. In BMM group, RR and TRM in the first year were 27.4%, 24.5% respectively, the third year were 38.9%, 46.4% and the fifth year were 39.2%, 48.2%. However, there was no significant difference in the indicator of OS, DFS, RR, TRM in the two groups.
CONCLUSIONAllo-HSCT could make some Ⅲ,Ⅳ NHL patients achieve long-term disease- free survival, but the TRM was still high relatively. Moreover, compared with the program of BMM conditioning regimen, Cy-fTBI might reduce the TRM and RR, meanwhile, increase the DFS and OS. However, due to the small number cases of two groups, there was no statistical significant difference.