Fevzi ALTUNTAŞ, Bahar UNCU ULU, Mehmet Sinan DAL, Tuğçe Nur YİĞENOĞLU, Derya ŞAHİN, Merih KIZIL ÇAKAR

Periferik T Hücreli Lenfoma Hastarında Otolog Kök Hücre Nakli için Uygun Zamanlama İlk Tam Remisyon mudur?

Amaç: Periferik T hücre lenfomalı (PTHL) çoğu hasta için sonuçlar, düşük yanıt oranları ve kısa remisyon süreleri ile kötü seyreder. Merkezimizde otolog kök hücre transplantasyonu (OKHN) yapılan PTHL hastalarının sonuçlarının analizini ve PTHL’li hastalarda OKHN için ilk tam remisyonun (TR) optimal zamanlama olup olmadığını araştırmayı amaçladık. Gereç ve Yöntem: Merkezimizde Ocak 2010 ile Aralık 2020 arasında OKHN uygulanan PTHL hastalarının verileri geriye dönük olarak incelendi. Bulgular: PTHL’li 25 hastaya OKHN uygulandı. Ortanca OKHN yaşı 44 (19-68) yıl olarak saptandı. Hastaların %68’ine ilk TR’den sonra upfront OKHN yapılırken, %32’sine relaps veya refrakter (R/R) hastalıktan sonra OKHN yapıldı. Tanıdan itibaren ortanca takip süresi 40 aydı (13-144 ay). Beş yıllık progresyonsuz sağkalım (PS) ve toplam sağkalım (TS) sırasıyla %50,8 ve %55,7 idi. Beş yıllık TS upfront OKHN grubunda %82,4 iken, R/R hastalarda %15,6 idi (p=0,019). OKHN öncesi TR2’de olan hastalarda ortanca TS 25 ay [%95 güven aralığı (GA): 0-50,4] iken, OKHN öncesi kısmi yanıtı olan hastalarda 13 ay (%95 GA: 0-35) idi (p=0,03). PTHL alt tiplerine göre TS ve PS tüm gruplarda istatistiksel olarak farklı saptanmadı (sırasıyla p=0,96 ve p=0,79). Sonuç: PTHL hastalarında prognoz kötü olsa dahi, TS, upfront OKHN yapılan grupta önemli oranda daha uzun saptandı. Hastalar ilk TR’de OKHN ile konsolide edilmeli ve OKHN yapmak için relaps beklenmemelidir.

Is the Optimal Timing First Complete Remission for Autologous Stem Cell Transplantation in Patients with Peripheral T-Cell Lymphoma?

Aim: Outcome for most patients with peripheral T-cell lymphomas (PTCLs) is poor, with low response rates and short durations of remission. We aimto analyze the outcome of PTCL patients who underwent autologous stem cell transplantation (ASCT) at our center and we researched whether firstcomplete remission (CR) was the optimal timing for ASCT in patients with PTCL.Materials and Methods: The data of PTCL patients who underwent ASCT between January 2010 and December 2020 at our center wereretrospectively analyzed.Results: Twenty-five patients with PTCL underwent ASCT. The median ASCT age was 44 years (range: 19-68). 68% of the patients were performedupfront ASCT after the first CR; 32% of the patients underwent ASCT after relapse or refractory (R/R) disease. The median follow-up time fromdiagnosis was 40 months (13-144 months). The five-year PFS and OS were 50.8% and 55.7%, respectively. Five-year OS was 82.4% in the up-frontASCT group, while the five-year OS was 15.6% in the R/R patients (p=0.019). The median OS was 25 months [95% confidence interval (CI): 0-50.4]in patients who had CR2, while it was 13 months (95% CI: 0-35) in patients who had PR before ASCT (p=0.03). According to subtypes of PTCL, OSand PFS were not statistically different in all groups (p=0.96 and p=0.79, respectively).Conclusion: Even the prognosis is poor in patients with PTCL, Overall survival was significantly longer among the upfront ASCT group. Patientsshould be consolidated with ASCT in the first CR, and relapse should not be waited to perform ASCT.

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