Allogeneic haematopoietic stem cell transplantation as a promising treatment for natural killer-cell neoplasms

被引:107
作者
Murashige, N
Kami, M
Kishi, Y
Kim, SW
Takeuchi, M
Matsue, K
Kanda, Y
Hirokawa, M
Kawabata, Y
Matsumura, T
Kusumi, E
Hirabayashi, N
Nagafuji, K
Suzuki, R
Takeuchi, K
Oshimi, K
机构
[1] Natl Canc Ctr, Haematopoiet Stem Cell Transplantat Unit, Chuo Ku, Tokyo 1040045, Japan
[2] Univ Tokyo, Dept Cell Therapy & Transplantat Med, Tokyo, Japan
[3] Akita Univ, Sch Med, Dept Internal Med 3, Akita 010, Japan
[4] Nagoya Daini Red Cross Hosp, Dept Internal Med 1, Nagoya, Aichi, Japan
[5] Kyushu Univ, Fac Med, Dept Internal Med 1, Fukuoka 812, Japan
[6] Aichi Canc Ctr, Res Inst, Div Mol Med, Aichi, Japan
[7] Canc Inst Hosp, Dept Pathol, Tokyo, Japan
[8] Juntendo Univ, Sch Med, Div Haematol, Tokyo, Japan
关键词
graft-versus-lymphoma effect; chemosensitivity; progression-free survival; overall survival; disease progression;
D O I
10.1111/j.1365-2141.2005.05651.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The efficacy of allogeneic haematopoietic stem-cell transplantation (allo-HSCT) for natural killer (NK)-cell neoplasms is unknown. We investigated the results of allo-HSCT for NK-cell neoplasms between 1990 and 2003 through questionnaires. After reclassification by a haematopathologist, of 345 patients who underwent allo-HSCT for malignant lymphoma, 28 had NK-cell neoplasms (World Health Organization classification): extranodal NK/T-cell lymphoma (n = 22), blastic NK-cell lymphoma (n = 3), and aggressive NK-cell leukaemia (n = 3). Twelve were chemosensitive and 16 chemorefractory. Twenty-two had matched-related donors. Stem-cell source was bone marrow in eight and mobilised peripheral blood in 20. Conditioning regimens were myeloablative (n = 23) and non-myeloablative (n = 5). Grade 2-4 acute graft-versus-host disease (GVHD) and chronic GVHD developed in 12 and 8 respectively. Eight died of disease progression, three of infection, two of acute GVHD, one of veno-occlusive disease, one of interstitial pneumonitis, and one of thrombotic microangiopathy. Two-year progression-free and overall survivals were 34% and 40% respectively (median follow-up, 34 months). All patients who did not relapse/progress within 10 months achieved progression-free survival (PFS) during the follow-up. In multivariate analysis, stem cell source (BM versus peripheral blood; relative risk 3.03), age (>= 40 years vs. < 40 years; relative risk 2.85), and diagnoses (extranodal NK/T-cell lymphoma versus others; relative risk 3.94) significantly affected PFS. Allo-HSCT is a promising treatment for NK-cell neoplasms.
引用
收藏
页码:561 / 567
页数:7
相关论文
共 28 条
[1]   Autologous stem cell transplantation for nasal NK/T-cell lymphoma: a progress report on its value [J].
Au, WY ;
Lie, AKW ;
Liang, R ;
Kwong, YL ;
Yau, CC ;
Cheung, MMC ;
Ngan, KC ;
Lau, WH ;
Wong, KH ;
Yiu, HY ;
Cheng, HC ;
Au, KH ;
Chan, JKC .
ANNALS OF ONCOLOGY, 2003, 14 (11) :1673-1676
[2]   REGIMEN-RELATED TOXICITY IN PATIENTS UNDERGOING BONE-MARROW TRANSPLANTATION [J].
BEARMAN, SI ;
APPELBAUM, FR ;
BUCKNER, CD ;
PETERSEN, FB ;
FISHER, LD ;
CLIFT, RA ;
THOMAS, ED .
JOURNAL OF CLINICAL ONCOLOGY, 1988, 6 (10) :1562-1568
[3]   The graft-versus-lymphoma effect: Fact, fiction, or opportunity? [J].
Bishop, MR .
JOURNAL OF CLINICAL ONCOLOGY, 2003, 21 (20) :3713-3715
[4]  
Chan J, 2001, WHO CLASSIFICATION T
[5]  
CHAN J, 2001, WHO CLASSIFICATION
[6]   Nonnasal lymphoma expressing the natural killer cell marker CD56: A clinicopathologic study of 49 cases of an uncommon aggressive neoplasm [J].
Chan, JKC ;
Sin, VC ;
Wong, KF ;
Ng, CS ;
Tsang, WYW ;
Chan, CH ;
Cheung, MMC ;
Lau, WH .
BLOOD, 1997, 89 (12) :4501-4513
[7]   Primary non-Hodgkin's lymphoma of the nose and nasopharynx: Clinical features, tumor immunophenotype, and treatment outcome in 113 patients [J].
Cheung, MMC ;
Chan, JKC ;
Lau, WH ;
Foo, W ;
Chan, PTM ;
Ng, CS ;
Ngan, RKC .
JOURNAL OF CLINICAL ONCOLOGY, 1998, 16 (01) :70-77
[8]   Primary nasal natural killer cell lymphoma: long-term treatment outcome and relationship with the International Prognostic Index [J].
Chim, CS ;
Ma, SY ;
Au, WY ;
Choy, C ;
Lie, AKW ;
Liang, R ;
Yau, CC ;
Kwong, YL .
BLOOD, 2004, 103 (01) :216-221
[9]  
CLIFT RA, 1990, BLOOD, V76, P1867
[10]   Transplant-related mortality and long-term graft function are significantly influenced by cell dose in patients undergoing allogeneic marrow transplantation [J].
Dominietto, A ;
Lamparelli, T ;
Raiola, AM ;
Van Lint, MT ;
Gualandi, F ;
Berisso, G ;
Bregante, S ;
di Grazia, C ;
Soracco, M ;
Pitto, A ;
Frassoni, F ;
Bacigalupo, A .
BLOOD, 2002, 100 (12) :3930-3934