27例自体造血干细胞移植治疗外周T细胞淋巴瘤疗效分析

Efficacy Analysis in 27 Patients with Peripheral T-Cell Lymphoma Treated with Autologous Hematopoietic Stem Cell Transplantation

摘要: 目的：评估自体造血干细胞移植(Autologous Hematopoietic Stem Cell Transplantation, ASCT)治疗外周T细胞淋巴瘤(Peripheral T-Cell Lymphoma, PTCL)的疗效，并探讨移植前后临床因素对患者预后的影响。方法：采用回顾性研究，纳入2011年11月~2023年6月在青岛市区三家医疗中心接受自体造血干细胞移植的27例PTCL患者，随访截止日期为2025年6月30日。采用Kaplan-Meier法评估移植后患者的无进展生存率(PFS)及总生存率(OS)，并通过Cox比例风险回归模型分析患者移植前后临床因素对生存预后的影响。结果：纳入分析的27例PTCL患者中，男性18例，女性9例，中位年龄为46岁(11~67岁)。ASCT移植前12例患者获得CR，15例患者达到PR。截至随访终点，3例患者死亡，其中1例为外周T细胞淋巴瘤-NOS，2例为ALK(−)间变性大细胞淋巴瘤，中位随访时间为55个月(2~83个月)。患者3年无进展生存率66.7%，总生存率74.1%。单因素及多因素Cox回归分析显示，24个月内疾病进展(POD24)是影响患者生存的重要独立预测因素。多因素Cox回归分析显示，女性、移植前接受西达苯胺靶向治疗的患者移植后可获得更长的总生存期，而其他移植前临床因素则对移植后患者总生存期、无进展生存期无显著影响。结论：ASCT是PTCL的有效治疗手段，POD24是独立预后因素，患者性别、移植前是否进行靶向治疗会影响移植后患者总生存期。

Abstract: Objective: To evaluate the efficacy of autologous hematopoietic stem cell transplantation (ASCT) in the treatment of peripheral T-cell lymphoma (PTCL) and to explore the impact of clinical factors before and after transplantation on patient prognosis. Methods: A retrospective study was conducted on 27 PTCL patients who underwent ASCT at three medical centers in Qingdao between November 2011 and June 2023, with follow-up until June 30, 2025. The Kaplan-Meier method was used to assess post-transplantation progression-free survival (PFS) and overall survival (OS). The Cox proportional hazards regression model was employed to analyze the influence of clinical factors before and after transplantation on survival outcomes. Results: Among the 27 PTCL patients analyzed, 18 were male and 9 were female, with a median age of 46 years (range: 11 - 67). Prior to ASCT, 12 patients achieved complete remission (CR), and 15 achieved partial remission (PR). By the follow-up endpoint, 3 patients had died, including 1 with PTCL-NOS and 2 with ALK(−) anaplastic large cell lymphoma. The median follow-up duration was 55 months (range: 2 - 83). The 3-year PFS and OS rates were 66.7% and 74.1%, respectively. Univariate and multivariate Cox regression analyses identified disease progression within 24 months (POD24) as a significant independent predictor of survival. Multivariate analysis further indicated that female patients and those who received chidamide-targeted therapy before transplantation had significantly longer OS after transplantation. Other pre-transplant clinical factors did not show a significant impact on post-transplant OS or PFS. Conclusion: ASCT is an effective treatment for PTCL. POD24 is an independent prognostic factor, while patient gender and the administration of targeted therapy before transplantation influence overall survival after transplantation.