自體造血干細胞移植治療侵襲性NK/T細胞淋巴瘤_《華西醫學》

作者：

牛挺 , 陳心傳 , 薛紅利 , 李建軍 , 劉志剛 ,  劉霆

四川大學華西醫院血液科（成都，610041）;

關鍵詞：

侵襲性NK/T細胞淋巴瘤自體造血干細胞移植治療

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【摘要】　目的　探討自體造血干細胞移植（autologous hematopoietic stem cell transplantation，auto-HSCT）治療侵襲性NK/T細胞淋巴瘤的療效。　方法　對我科2005年1月16日收治的1例侵襲性NK/T細胞淋巴瘤患者的造血干細胞移植和隨訪資料進行回顧性分析，并復習國內外相關文獻。　結果　患者為37歲女性，診斷結外鼻型NK/T細胞淋巴瘤，系統性，經CHOAP和ICE方案化學療法、手術、局部放射治療控制病情良好后，采集自體骨髓造血干細胞，行auto-HSCT，預處理方案為全身放射治療+ECy；移植+29 d造血功能即順利重建；移植后密切隨訪，患者一直處于完全緩解，至今已存活67個月。　結論　 auto-HSCT治療侵襲性NK/T細胞淋巴瘤療效肯定、可靠。
【Abstract】　Objective　 To explore the therapeutic effect of autologous hematopoietic stem cell transplantation (auto-HSCT) on aggressive NK/T lymphoma.　Methods　 The clinical data of one patient with aggressive NK/T lymphoma diagnosed in January 2005 were retrospectively analyzed, and the relevant domestic literatures were analyzed.　Results　 This thirty-seven-year-old female patient had good disease control after undergoing chemotherapy with CHOAP and ICE regimens, surgery, and locoregional radiotherapy. After that, she had been collected enough bone marrow-derived hematopoietic stem cells, then underwent auto-HSCT with these cells. The conditioning regimen was TBI plus ECy. On the +29th day after transplantation,the hematopoietic reconstruction was successful. During the follow-up period, the patient was in complete remission status all along and her disease-free survival (DFS) was 67 months.　Conclusion　 Auto-HSCT is effective on aggressive NK/T lymphoma.

引用本文： 牛挺,陳心傳,薛紅利,李建軍,劉志剛,劉霆. 自體造血干細胞移植治療侵襲性NK/T細胞淋巴瘤. 華西醫學, 2011, 26(12): 1763-1766. doi: 復制

1.	Jaff ES, Harris NL, Chan JK, et al. Proposed world health organization classification of neoplastic diseases of hematopoietic and lymphoid tissues[J]. Am J Surg Pathol, 1997, 21(2): 114-121.
2.	Chan JK. The new World Health Organization classification of the lymphomas: the past, the present and the future[J]. Hematol Oncol, 2001, 19(4): 129-150.
3.	Murashige N, Kami M, Kishi Y, et al. Allogeneic haematopoietic stem cell transplantation as a promising treatment for natural killer-cell neoplasms[J]. Br J Haematol, 2005, 130(4): 561-567.
4.	Chan JK, Sin VC, Wong KF, et al. Nonnasal lymphoma expressing the natural killer cell marker CD56: a clinicopathologic study of 49 cases of an uncommon aggressive neoplasm[J]. Blood, 1997, 89(12): 4501-4513.
5.	Swerdlow SH, Campo E, Harris NL, et al. WHO classification of tumors of hematopoietic and lymphoid tissues[M]. 4th ed. Extranodal NK/T-cell lymphoma, nasal type. International agency for research on cancer. Lyon: 2008: 285-288.
6.	Li YX, Coucke PA, Li JY, et al. Primary non-Hodgkin′s lymphoma of the nasal cavity: prognostic significance of paranasal extension and the role of radiotherapy and chemotherapy[J]. Cancer, 1998, 83(3): 449-456.
7.	Pagano L, Gallamini A, Trapè G, et al. NK/T-cell lymphomas “nasal type”: an Italian multicentric retrospective survey[J]. Ann Oncol, 2006, 17(5): 794-800.
8.	You JY, Chi KH, Yang MH, et al. Radiation therapy versus chemotherapy as initial treatment for localized nasal natural killer (NK) /T-cell lymphoma: a single institute survey in Taiwan[J]. Ann Oncol, 2004, 15(4): 618-625.
9.	Chim C, Ma S, Au SY, et al. Primary nasal natural killer cell lymphoma: long-term treatment outcome and relationship with the International Prognostic Index[J]. Blood, 2004, 103(1): 216-221.
10.	Ribrag V, Ell Hajj M, Janot F, et al. Early locoregional high-dose radiotherapy is associated with long-term disease control in localized primary angiocentric lymphoma of the nose and nasopharynx[J]. Leukemia, 2001, 15(7): 1123-1126.
11.	Li YX, Yao B, Jin J, et al. Radiotherapy as primary treatment for stage IE and IIE nasal natural killer/T-cell lymphoma[J]. J Clin Oncol, 2006, 24(1): 181-189.
12.	Yong W, Zheng W, Zhu J, et al. Midline NK/T-cell lymphoma nasal-type: treatment outcome, the effect of L-asparaginase based regimen, and prognostic factors[J]. Hematol Oncol, 2006, 24(1): 28-32.
13.	Kim S, Kim J, Choi BS. Treatment outcome of front-line systemic chemotherapy for localized extranodal NK/T cell lymphoma in nasal and upper aerodigestive tract[J]. Leuk Lymphoma, 2006, 47(7): 1265-1273.
14.	Lee J, Kim WS, Park YH, et al. Nasal-type NK/T cell lymphoma: clinical features and treatment outcome[J]. Br J Cancer, 2005, 92(7): 1226-1230.
15.	趙靜, 易成. 鼻和鼻型NK/T細胞淋巴瘤的治療進展[J]. 中國腫瘤臨床, 2006, 33(14): 836-839.
16.	Okamura T, Kishimoto T, Inoue M, et al. Unrelated bone marrow transplantation for Epstein-Barr virus-associated T/NK cell lymphoproliferative disease[J]. Bone Marrow Transplant, 2003, 31(2): 105-111.
17.	Reimer P. Impact of autologous and allogeneic stem cell transplantation in peripheral T-cell lymphoma[J].Adv Hematol, 2010, 2010: 1-12.
18.	Lee J, Park YH, Kim WS, et al. Extranodal nasal type NK/T cell lymphoma: elucidating clinical prognostic factors for risk-based stratification of therapy[J]. Eur J Cancer, 2005, 41(10): 1402-1408.
19.	Koizumi K, Fujmoto K, Haseyama Y, et al. Effective high-dose chemotherapy combined with CD34+-selected peripheral blood stem cell transplantation in a patient with ctaneous involvement of nasal NK/T-cell lymphoma[J]. Eur J Haemtol, 2004, 72(2): 140-144.
20.	Yokoyama H, Yamada MF, Ishizawa K, et al. Successful treatment of advanced extranodal NK/T cell lymphoma with unrelated cord blood transplantation[J]. Tohoku J Exp Med, 2007, 211(4): 395-359.
21.	Corradini P, Dodero A, Zallio F, et al. Graft-versus lymphoma effect in ralapsed peripheral T-cell non-Hodgkin′s lymphomas after reduced-intensity conditioning followed by allogeneic transplantation of hematopoietic cells[J]. J Clin Oncol, 2004, 22(11): 2172-2176.

1. 　Jaff ES, Harris NL, Chan JK, et al. Proposed world health organization classification of neoplastic diseases of hematopoietic and lymphoid tissues[J]. Am J Surg Pathol, 1997, 21(2): 114-121.
2. 　Chan JK. The new World Health Organization classification of the lymphomas: the past, the present and the future[J]. Hematol Oncol, 2001, 19(4): 129-150.
3. 　Murashige N, Kami M, Kishi Y, et al. Allogeneic haematopoietic stem cell transplantation as a promising treatment for natural killer-cell neoplasms[J]. Br J Haematol, 2005, 130(4): 561-567.
4. 　Chan JK, Sin VC, Wong KF, et al. Nonnasal lymphoma expressing the natural killer cell marker CD56: a clinicopathologic study of 49 cases of an uncommon aggressive neoplasm[J]. Blood, 1997, 89(12): 4501-4513.
5. 　Swerdlow SH, Campo E, Harris NL, et al. WHO classification of tumors of hematopoietic and lymphoid tissues[M]. 4th ed. Extranodal NK/T-cell lymphoma, nasal type. International agency for research on cancer. Lyon: 2008: 285-288.
6. 　Li YX, Coucke PA, Li JY, et al. Primary non-Hodgkin′s lymphoma of the nasal cavity: prognostic significance of paranasal extension and the role of radiotherapy and chemotherapy[J]. Cancer, 1998, 83(3): 449-456.
7. 　Pagano L, Gallamini A, Trapè G, et al. NK/T-cell lymphomas “nasal type”: an Italian multicentric retrospective survey[J]. Ann Oncol, 2006, 17(5): 794-800.
8. 　You JY, Chi KH, Yang MH, et al. Radiation therapy versus chemotherapy as initial treatment for localized nasal natural killer (NK) /T-cell lymphoma: a single institute survey in Taiwan[J]. Ann Oncol, 2004, 15(4): 618-625.
9. 　Chim C, Ma S, Au SY, et al. Primary nasal natural killer cell lymphoma: long-term treatment outcome and relationship with the International Prognostic Index[J]. Blood, 2004, 103(1): 216-221.
10. 　Ribrag V, Ell Hajj M, Janot F, et al. Early locoregional high-dose radiotherapy is associated with long-term disease control in localized primary angiocentric lymphoma of the nose and nasopharynx[J]. Leukemia, 2001, 15(7): 1123-1126.
11. 　Li YX, Yao B, Jin J, et al. Radiotherapy as primary treatment for stage IE and IIE nasal natural killer/T-cell lymphoma[J]. J Clin Oncol, 2006, 24(1): 181-189.
12. 　Yong W, Zheng W, Zhu J, et al. Midline NK/T-cell lymphoma nasal-type: treatment outcome, the effect of L-asparaginase based regimen, and prognostic factors[J]. Hematol Oncol, 2006, 24(1): 28-32.
13. 　Kim S, Kim J, Choi BS. Treatment outcome of front-line systemic chemotherapy for localized extranodal NK/T cell lymphoma in nasal and upper aerodigestive tract[J]. Leuk Lymphoma, 2006, 47(7): 1265-1273.
14. 　Lee J, Kim WS, Park YH, et al. Nasal-type NK/T cell lymphoma: clinical features and treatment outcome[J]. Br J Cancer, 2005, 92(7): 1226-1230.
15. 　趙靜, 易成. 鼻和鼻型NK/T細胞淋巴瘤的治療進展[J]. 中國腫瘤臨床, 2006, 33(14): 836-839.
16. 　Okamura T, Kishimoto T, Inoue M, et al. Unrelated bone marrow transplantation for Epstein-Barr virus-associated T/NK cell lymphoproliferative disease[J]. Bone Marrow Transplant, 2003, 31(2): 105-111.
17. 　Reimer P. Impact of autologous and allogeneic stem cell transplantation in peripheral T-cell lymphoma[J].Adv Hematol, 2010, 2010: 1-12.
18. 　Lee J, Park YH, Kim WS, et al. Extranodal nasal type NK/T cell lymphoma: elucidating clinical prognostic factors for risk-based stratification of therapy[J]. Eur J Cancer, 2005, 41(10): 1402-1408.
19. 　Koizumi K, Fujmoto K, Haseyama Y, et al. Effective high-dose chemotherapy combined with CD34+-selected peripheral blood stem cell transplantation in a patient with ctaneous involvement of nasal NK/T-cell lymphoma[J]. Eur J Haemtol, 2004, 72(2): 140-144.
20. 　Yokoyama H, Yamada MF, Ishizawa K, et al. Successful treatment of advanced extranodal NK/T cell lymphoma with unrelated cord blood transplantation[J]. Tohoku J Exp Med, 2007, 211(4): 395-359.
21. 　Corradini P, Dodero A, Zallio F, et al. Graft-versus lymphoma effect in ralapsed peripheral T-cell non-Hodgkin′s lymphomas after reduced-intensity conditioning followed by allogeneic transplantation of hematopoietic cells[J]. J Clin Oncol, 2004, 22(11): 2172-2176.

《華西醫學》

自體造血干細胞移植治療侵襲性NK/T細胞淋巴瘤

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《華西醫學》

自體造血干細胞移植治療侵襲性NK/T細胞淋巴瘤

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