Efficacy and influencing factors of autologous hematopoietic stem cell transplantation in the treatment of malignant lymphoma
10.3969/j.issn.2095-4344.3510
- Author:
Linlin CAO
1
Author Information
1. Department of Hematology, Western District, The First Affiliated Hospital of University of Science and Technology of China
- Publication Type:Journal Article
- Keywords:
Autologous hematopoietic stem cell transplantation;
Curative effect;
Influencing factors;
Lymphoma;
Overall survival rate;
Progression free survival rate;
Stem cells
- From:
Chinese Journal of Tissue Engineering Research
2020;25(13):1993-1998
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: Chemotherapy, local radiotherapy, autologous peripheral blood stem cell transplantation and cellular immunotherapy are the treatment options for lymphoma. High-dose chemotherapy combined with autologous hematopoietic stem cell transplantation can significantly prolong the survival time and improve the prognosis of patients. It is recommended as the first-line treatment for relapsed refractory and (or) highly invasive lymphoma. OBJECTIVE: To explore the influencing factors of high-dose chemotherapy combined with autologous hematopoietic stem cell transplantation in lymphoma. METHODS: The clinical records of 74 lymphoma patients after high-dose chemotherapy combined with autologous hematopoietic stem cell transplantation in Transplantation Ward, Department of Hematology, West District of The First Affiliated Hospital of University of Science and Technology of China from October 2015 to March 2020 were collected and analyzed retrospectively to evaluate efficacy and prognostic factors of autologous hematopoietic stem cell transplantation for lymphoma. RESULTS AND CONCLUSION: (1) The follow-up period was up to May 15, 2020. The median time from diagnosis to transplantation was 8(3-83) months, and the median follow-up time was 17(2-59) months. (2) All patients obtained hematopoietic reconstruction after transplantation. The median time for granulocyte implantation was +10(+8-+17) days, and the median time for platelet implantation was +12(+9-+22) days. (3) There were 60 cases of progression-free survival after transplantation, 13 cases of recurrence, 11 of the relapsed patients died, and 1 died of lung infection 11 months after transplantation. (4) All four patients with progression disease before transplantation died within 7 months after transplantation due to the progression of the primary disease. (5) The 2-year overall survival rate after receiving autologous hematopoietic stem cell transplantation was 78.5%; the 2-year progression-free survival rate was 75.8%. Patients with international prognostic index ≤ 2 points before transplantation and international prognostic index > 2 points had 93.9% and 66.4% overall survival at 2 years after transplantation (P=0.003); progression-free survival rates at 2 years were 85.6% and 65.5% (P=0.017), respectively. (6) The two-year overall survival rates of patients with bone marrow invasion and no bone marrow invasion before transplantation were 55.5% and 91.9% (P=0.001) respectively. The 2-year progression-free survival rates were 53.1% and 88.7% (P < 0.001), respectively. (7) The 2-year overall survival rate of patients in clinical staging (stages I and II) was better than that in clinical staging (stages III and IV) (100% vs. 82.5%, P=0.026). The 2-year progression-free survival rate of first-line consolidation patients was better than that of rescue group (84% vs. 48.9%, P=0.01). There was no statistically significant difference in the effects of patient age and degree of remission before transplantation on progression-free survival and overall survival. (8) Results found that high-dose chemotherapy combined with autologous hematopoietic stem cell transplantation could significantly improve the survival and prognosis of patients with lymphoma, and had high safety. It can be used as a safe and effective treatment for lymphoma. International prognostic index score, the presence or absence of bone marrow invasion, the timing of transplantation, and the stage of primary disease are relative to the prognosis of involved patients.
