Outcomes of 33 patients with anaplastic large cell lymphoma treated after hematopoietic stem cell transplantation

Ning LU; Xiaofan LI; Yujun Dong; Yini Wang; Xiaorui FU; Yamei WU; Yuhang LI; Maihong Wang; Nainong LI; Hanyun Ren; Zhao Wang; Mingzhi Zhang; Xiaoxiong WU; Liangding HU; Yao Liu; Wenrong Huang

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Outcomes of 33 patients with anaplastic large cell lymphoma treated after hematopoietic stem cell transplantation

VernacularTitle: 造血干细胞移植治疗间变大细胞淋巴瘤的临床分析
Author: Ning LU ¹ ; Xiaofan LI ² ; Yujun DONG ³ ; Yini WANG ⁴ ; Xiaorui FU ⁵ ; Yamei WU ⁶ ; Yuhang LI ⁷ ; Maihong WANG ⁸ ; Nainong LI ² ; Hanyun REN ³ ; Zhao WANG ⁴ ; Mingzhi ZHANG ⁵ ; Xiaoxiong WU ⁶ ; Liangding HU ⁷ ; Yao LIU ⁸ ; Wenrong HUANG ¹
Author Information

1. Department of Hematology, Chinese PLA General Hospital, Beijing 100853, China
2. Department of Hematology, Union Hospital of Fujian Medical University, Fuzhou 350001, China
3. Department of Hematology, Peking University First Hospital, Beijing 100034, China
4. Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
5. Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
6. Department of Hematology, No. 304 Hospital of Chinese PLA, Beijing 100037, China
7. Department of Hematopoietic Stem Cell Transplantation, No. 307 Hospital of Chinese PLA, Beijing 100071, China
8. Department of Hematology, Xinqiao Hospital, Army Medical University, Chongqing 400037, China
Publication Type:Journal Article
Keywords: Anaplastic large cell lymphoma; Hematopoietic stem cell transplantation; Clinical analysis; Prognosis
From: Chinese Journal of Hematology 2020;41(2):117-122
CountryChina
Language:Chinese
Abstract: Objective:To explore the efficacy and prognostic factors of hematopoietic stem cell transplantation (HSCT) for the treatment of patients with anaplastic large cell lymphoma (ALCL) .
Methods:The clinical records of 33 ALCL patients after HSCT were collected and analyzed retrospectively to evaluate the rates of overall survival (OS) and recurrence after autologous (auto-HSCT) and allogeneic HSCT (allo-HSCT) and the factors influencing prognosis.
Results:The median-age of this cohort of 33 ALCL cases at diagnosis was 31 (12-57) years old with a male/female ratio of 23/10, 24 cases (72.7%) were ALK⁺ and 9 ones (27.3%) ALK^-. Of them, 25 patients (19 ALK⁺ and 6 ALK^-) underwent auto-HSCT and 8 cases (5 ALK⁺ and 3ALK^-) allo-HSCT with a median follow-up of 18.7 (4.0-150.0) months. Disease states before HSCT were as follows: only 6 patients achieved CR status and received auto-HSCT, 16 patients achieved PR (14 cases by auto-HSCT and 2 ones allo-HSCT) , the rest 11 cases were refractory/relapse (5 cases by auto-HSCT and 6 ones allo-HSCT) . There were 7 cases died of disease progression (5 after auto-HSCT and 2 allo-HSCT) and 5 cases treatment-related mortality (TRM) (2 after auto-HSCT and 3 allo-HSCT) , TRM of two groups were 8.0% and 37.5%, respectively. Both the median progression-free survival (PFS) and OS were 15 months after auto-HSCT, the median PFS and OS after allo-HSCT were 3.7 (1.0-90.0) and 4.6 (1.0-90.0) months, respectively. There was no statistically significant difference in terms of survival curves between the two groups (OS and PFS, P=0.247 and P=0.317) . The 2-year OS rates in auto-HSCT and allo-HSCT groups were 72% and 50%, respectively. The 5-year OS rates in auto-HSCT and allo-HSCT groups were 36% and 25%, respectively.
Conclusion:ALCL treated by chemotherapy produced high rates of overall and complete responses. Chemotherapy followed by auto-HSCT remained to be good choice for patients with poor prognostic factors. High-risk patients should be considered more beneficial from allo-HSCT.