Disappointing outcome of autologous stem cell transplantation for enteropathy-associated T-cell lymphoma

被引:63
|
作者
Al-Toma, A.
Verbeek, W. H. M.
Visser, O. J.
Kuijpers, K. C.
Oudejans, J. J.
Kluin-Nelemans, H. C.
Mulder, C. J. J.
Huijgens, P. C.
机构
[1] Vrije Univ Amsterdam Med Ctr, Dept Gastroenterol, Amsterdam, Netherlands
[2] Vrije Univ Amsterdam Med Ctr, Dept Haematol, Amsterdam, Netherlands
[3] Vrije Univ Amsterdam Med Ctr, Dept Clin Pathol, Amsterdam, Netherlands
[4] St Antonius Hosp, Dept Clin Pathol, Nieuwegein, Netherlands
[5] Univ Groningen, Univ Med Ctr Groningen, Dept Haematol, Groningen, Netherlands
关键词
autologous stem cell transplantation; coeliac disease; enteropathy-associated T-cell lymphoma;
D O I
10.1016/j.dld.2007.03.009
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background. Despite treatment, enteropathy-associated T-cell lymphoma has a very poor outcome. Chemotherapy can be complicated by small bowel perforation, gastrointestinal bleeding and development of enterocolic fistulae. Here we report on the feasibility, safety and efficacy of high-dose chemotherapy followed by autologous stem cell transplantation in patients with enteropathy-associated T-cell lymphoma (three upfront and one at relapse), with or without prior partial small bowel resection. Methods. Four patients [two males, two females, mean age 65 years (range 60-69 years)] received high-dose chemotherapy followed by autologous stem cell transplantation. Partial small bowel resection has been performed in three patients. Results. All four patients completed the mobilization and leucopheresis procedures successfully and subsequently received conditioning chemotherapy and transplantation. Engraftment occurred in all patients. No major non-haematological toxicity or transplantation-related mortality was observed. One patient has ongoing complete remission 32 months after transplantation. Three patients died from relapse within few months after autologous stem cell transplantation. Conclusions. Autologous stem cell transplantation seems unsatisfactory for patients with enteropathy-associated T-cell lymphoma. More intensive conditioning and aggressive chemotherapy with/or without targeted immunotherapy as well as allogenous stem cell transplantation needs to be explored. (C) 2007 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:634 / 641
页数:8
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