[Efficacy and safety of TBI+rATG-based conditioning regimen for haploidentical allogeneic hematopoietic stem cell transplantation in 11 cases of chemotherapy-resistant advanced peripheral T-cell lymphoma].
Zhonghua Xue Ye Xue Za Zhi
; 44(7): 578-581, 2023 Jul 14.
Article
in Zh
| MEDLINE
| ID: mdl-37749039
ABSTRACT
Objective:
To evaluate the clinical outcomes and safety of haploidentical hematopoietic stem cell transplantation (haplo-HSCT) using a conditioning regimen based on total body irradiation (TBI) and rabbit anti-human thymocyte globulin (rATG) in the management of chemotherapy-resistant advanced peripheral T-cell lymphoma (PTCL) .Methods:
Clinical data of 11 patients with chemotherapy-resistant advanced PTCL who underwent haplo-HSCT with a TBI+rATG-based conditioning regimen at the Department of Hematology, Shanghai Liquan Hospital and Shanghai Zhaxin Integrated Traditional Chinese and Western Medicine Hospital, from September 2019 to December 2022 were retrospectively analyzed.Results:
â Among the 11 patients (six males and five females), with a median age of 40 years (range 22-58 years), there were six cases of PTCL, not otherwise specified (PTCL-NOS), three cases of angioimmunoblastic T-cell lymphoma (AITL), one case of large-cell transformation of mycosis fungoides (MF-LCT), and one case of T-cell large granular lymphocytic leukemia (T-LGLL). According to the Lugano staging system, all patients were in stage â ¢ or â £, and eight patients had B symptoms. Before transplantation, the median number of prior lines of chemotherapy was 4 (range 2-10), and all patients had progressive disease (PD). The median time from diagnosis to transplantation was 17 months (range 6-36 months). â¡The conditioning regimen consisted of a TBI dose of 10 Gy, administered at 2 Gy on day -8 and 4 Gy from day -7 to day -6, rATG was administered at a daily dose of 2.5 mg/kg from day -5 to day -2. Etoposide (VP-16) was given at a dose of 15 mg/kg/d from day -5 to day -4, while cyclophosphamide (CTX) was administered at a dose of 50 mg/kg/d from day -3 to day -2. In patients with central nervous system involvement, etoposide and cyclophosphamide were replaced with thiotepa (TT) at a dose of 5 mg/kg/d from day -5 to day -4. Additionally, cytarabine (Ara-C) was added at a dose of 2.0 g/m(2) twice a day from day -3 to day -2 into the conditioning. â¢Successful engraftment was achieved in all patients, with a median time to neutrophil engraftment of 14.5 d (range 11-16 d) and a median time to platelet engraftment of 13 days (range 8-18 days). Acute graft-versus-host disease (aGVHD) occurred in one patient (grade â -â ¡), and another patient experienced grade â ¢-â £ aGVHD. Among the eight survivors, four developed chronic GVHD (cGVHD). â£Post-transplantation, nine patients achieved complete response (CR). â¤Hematopoietic suppression occurred in all patients after conditioning, with three experiencing diarrhea, four developing mucositis, three exhibiting elevated transaminase/bilirubin levels, and seven developing infectious complications. These non-hematologic adverse events were effectively managed. â¥At one year post-transplantation, the non-relapse mortality (NRM) was (22.5±14.0) %, the cumulative incidence of relapse (CIR) was (20.2±12.7) %, and overall survival (OS) rate was (72.7±13.4) %, and disease-free survival (DFS) rate was (63.6±14.5) % .Conclusion:
TBI+rATG-based conditioning regimen for haplo-HSCT is an effective and safe treatment approach for patients with chemotherapy-resistant advanced PTCL.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Lymphoma, T-Cell, Peripheral
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Hematopoietic Stem Cell Transplantation
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Graft vs Host Disease
Limits:
Adult
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Female
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Humans
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Male
/
Middle aged
Country/Region as subject:
Asia
Language:
Zh
Journal:
Zhonghua Xue Ye Xue Za Zhi
Year:
2023
Document type:
Article
Affiliation country:
China