Haploidentical transplantation with post-transplant cyclophosphamide versus single cord blood transplantation in adults with relapsed/refractory non-Hodgkin lymphoma.

IF 4.5 2区医学 Q1 HEMATOLOGY

Bone Marrow Transplantation Pub Date : 2024-09-25 DOI:10.1038/s41409-024-02423-y

Masashi Nishikubo, Yoshimitsu Shimomura, Yosuke Nakaya, Akihito Shinohara, Naoyuki Uchida, Nobuyuki Takayama, Hikaru Kobayashi, Yasufumi Uehara, Jun Ishikawa, Kazuya Ishiwata, Nobuhiro Hiramoto, Hideyuki Nakazawa, Keisuke Kataoka, Junya Kanda, Koji Nagafuji, Yasuji Kozai, Yoshiko Matsuhashi, Fumihiko Ishimaru, Sung-Won Kim, Takahiro Fukuda, Yoshinobu Kanda, Yoshiko Atsuta, Eisei Kondo, Shinichi Kako

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引用次数: 0

Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative treatment for relapsed or refractory non-Hodgkin lymphoma (R/R NHL). Allo-HSCT using post-transplant cyclophosphamide (PTCY-haplo) and umbilical cord blood transplantation (uCBT) are important donor options in the absence of matched related siblings. However, the data comparing these two donor sources in R/R NHL are limited. Using the Japanese nationwide transplantation registry data, we identified 857 patients with R/R NHL, including 169 patients who received PTCY-haplo and 688 who received uCBT for their first allo-HSCT between January 2013 and December 2021; 514 patients (60%) had B-cell lymphoma. More PTCY-haplo recipients received allo-HSCT using a reduced-intensity conditioning regimen in recent years. The 3-year overall survival (OS), progression-free survival (PFS), and graft-versus-host disease (GVHD)-free/relapse-free survival (GRFS) rates in the PTCY-haplo and uCBT groups were 44% versus 39% (P = 0.326), 34% versus 33% (P = 0.660), and 19% versus 23% (P = 0.910), respectively; the adjusted hazard ratios for OS, PFS, and GRFS were 0.89 (95% confidence interval: 0.69-1.15, P = 0.373), 0.98 (0.78-1.22, P = 0.852), and 0.92 (0.83-1.21, P = 0.920), respectively. The PTCY-haplo group showed faster neutrophil and platelet engraftment and a lower incidence of grade III-IV acute GVHD. Thus, PTCY-haplo and uCBT could serve as alternative donor sources in patients with R/R NHL.

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对复发/难治性非霍奇金淋巴瘤成人患者进行单倍体移植和移植后环磷酰胺治疗与单一脐带血移植的比较。

异基因造血干细胞移植（allo-HSCT）是治疗复发或难治性非霍奇金淋巴瘤（R/R NHL）的一种治愈性疗法。使用移植后环磷酰胺（PTCY-haplo）的异基因造血干细胞移植（allo-HSCT）和脐带血移植（uCBT）是在没有匹配亲缘兄弟姐妹的情况下的重要供体选择。然而，在R/R NHL中比较这两种供体来源的数据非常有限。利用日本全国移植登记数据，我们确定了 857 例 R/R NHL 患者，其中包括在 2013 年 1 月至 2021 年 12 月期间首次接受异体 HSCT 的 169 例 PTCY-haplo 患者和 688 例 uCBT 患者；514 例患者（60%）患有 B 细胞淋巴瘤。近年来，更多的PTCY-haplo受者接受了采用强度降低的调理方案的allo-HSCT。PTCY-haplo组和uCBT组的3年总生存率（OS）、无进展生存率（PFS）和无移植物抗宿主病（GVHD）/无复发生存率（GRFS）分别为44%对39%（P = 0.326）、34%对33%（P = 0.660）和 19% 对 23% （P = 0.910）；OS、PFS 和 GRFS 的调整后危险比分别为 0.89（95% 置信区间：0.69-1.15，P = 0.373）、0.98（0.78-1.22，P = 0.852）和 0.92（0.83-1.21，P = 0.920）。PTCY-haplo 组的中性粒细胞和血小板移植速度更快，III-IV 级急性 GVHD 发生率更低。因此，PTCY-haplo和uCBT可作为R/R NHL患者的替代供体来源。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bone Marrow Transplantation 医学-免疫学

CiteScore

8.40

自引率

8.30%

发文量

337

审稿时长

6 months

期刊介绍： Bone Marrow Transplantation publishes high quality, peer reviewed original research that addresses all aspects of basic biology and clinical use of haemopoietic stem cell transplantation. The broad scope of the journal thus encompasses topics such as stem cell biology, e.g., kinetics and cytokine control, transplantation immunology e.g., HLA and matching techniques, translational research, and clinical results of specific transplant protocols. Bone Marrow Transplantation publishes 24 issues a year.