Efficacy and prognosis of autologous hematopoietic stem cell transplantation in treating recurrent refractory peripheral T cell lymphoma

Objective To investigate the clinical effect and prognostic factors of autologous hematopoietic stem cells transplantation(AHSCT) in the treatment of recurrent refractory peripheral T cell lymphoma. Methods Sixty-four cases of recurrent refractory peripheral T cell lymphoma admitted in Yinzhou people's Hospital between January 2010 and January 2016 received AHSCT treatment. The patients were followed up for the analysis of therapeutic effect and clinical characteristics, and the prognosis was analyzed by COX regression. Results Hematopoietic reconstitution in 64 patients within 15 days after AHSCT was observed. The median peripheral mononuclear cells were 8.74×10⁸/kg(6.34×10⁸-16.72×10⁸/kg), the median CD34 cell count was 5.64×10⁶/kg(3.43×10⁶-9.62×10⁶/kg). The median time of neutrophil implantation(>0.5×10⁹/L) was 12 d(7-17 d), the median time of platelet implantation(20×10⁹/L) was 13 d(7-19 d). The median time of follow-up was 26 months(8-48 months). By the end of the follow-up period, 28 cases of them died, the death rate was 43.75%(survival rate 56.25%); 24 cases died of recurrence and 4 cases died of transplantation related complications. Response rates: complete response(CR) 43.75%(28/64), partial response(PR) 32.81%(21/64), stable disease(SD) 21.88%(14/64). The 3-years overall survival was 59.38%. Three-year progression-free survival rate was 48.44%, the longest disease-free survival time was 41 months. Multivariate COX regression analysis showed that bone marrow involvement, the Prognostic Index for T-cell lymphoma(PIT) and complete response after AHSCT were independent factors of poor prognosis. Conclusion AHSCT has a significant effect on recurrent refractory peripheral T cell lymphoma. The bone marrow involvement, PIT score and CR after the transplantation will give a bad prognosis.