Autologous haematopoietic cell transplantation for non-Hodgkin lymphoma with secondary CNS involvement

作者：Maziarz Richard T; Wang Zhiwei; Zhang Mei Jie; Bolwell Brian J; Chen Andy I; Fenske Timothy S; Freytes Cesar O; Gale Robert P; Gibson John; Hayes Lattin Brandon M; Holmberg Leona; Inwards David J; Isola Luis M; Khoury Hanna J; Lewis Victor A; Maharaj Dipnarine; Munker Reinhold; Phillips Gordon L; Rizzieri David A; Rowlings Philip A; Saber Wael; Satwani Prakash; Waller Edmund K; Maloney David G; Montoto Silvia; Laport Ginna G; Vose Julie M

来源：British Journal of Haematology, 2013, 162(5): 648-656.

DOI：10.1111/bjh.12451

• central nervous system involvement
• non-Hodgkin lymphoma
• autologous transplantation
• outcomes

Pre-existing central nervous system (CNS) involvement may influence referral for autologous haematopoietic cell transplantation (AHCT) for patients with non-Hodgkin lymphoma (NHL). The outcomes of 151 adult patients with NHL with prior secondary CNS involvement (CNS+) receiving an AHCT were compared to 4688 patients without prior CNS lymphoma (CNS-). There were significant baseline differences between the cohorts. CNS+ patients were more likely to be younger, have lower performance scores, higher age-adjusted international prognostic index scores, more advanced disease stage at diagnosis, more aggressive histology, more sites of extranodal disease, and a shorter interval between diagnosis and AHCT. However, no statistically significant differences were identified between the two groups by analysis of progression-free survival (PFS) and overall survival (OS) at 5years. A matched pair comparison of the CNS+ group with a subset of CNS- patients matched on propensity score also showed no differences in outcomes. Patients with active CNS lymphoma at the time of AHCT (n=55) had a higher relapse rate and diminished PFS and OS compared with patients whose CNS lymphoma was in remission (n=96) at the time of AHCT. CNS+ patients can achieve excellent long-term outcomes with AHCT. Active CNS lymphoma at transplant confers a worse prognosis.

• 出版日期2013-9