【摘要】 目的：探讨真实世界自体造血干细胞移植（ASCT）治疗套细胞淋巴瘤（MCL）患者的疗效及预后影响因素。方法：回顾性分析2005年1月至2021年12月在北京大学第三医院等国内4家医院接受ASCT治疗的85例MCL患者的临床资料。移植前采用利妥昔单抗为基础的化疗方案，观察患者临床特征、治疗方案及生物学指标等对无进展生存（PFS）期和总生存（OS）期的影响。结果：85例患者中男性65例，女性20例，中位年龄53(34-68)岁；母细胞及多形型11例，经典型74例；Ann Arbor分期I-II期5例，III-IV期80例；18例Ki-67≥50%,29例有B症状，68例存在结外受累，56例使用大剂量阿糖胞苷，31例为复发难治性。移植后中位随访51(12-202)个月，5年预计PFS率为（68.4±6.0）%,5年预计OS率为（87.4±4.6）%。多因素Cox回归分析筛选影响预后的相关因素，结果显示，MIPI-c分期高中危/高危（HR=4.461,95%CI:1.822-10.918,P=0.001）及未进行维持治疗（HR=3.127,95%CI:1.398-6.991,P=0.005）是影响患者PFS的独立不良预后因素，复发难治状态（HR=4.727,95%CI:1.005-22.234,P=0.049）为影响患者OS的独立不良预后因素。结论：ASCT巩固治疗对改善年轻、一般状态良好MCL患者的PFS、OS具有重要意义，尤其是对于MIPI-c评分低危/低中危、ASCT后接受新药维持治疗及非复发、难治状态的患者。更多还原

【Abstract】 Objective:To investigate the efficacy and prognostic factors of autologous hematopoietic stem cell transplantation(ASCT) in the treatment of mantle cell lymphoma(MCL) in the real world.Methods:The clinical data of85 MCL patients who underwent ASCT in Peking University Third Hospital and other Chinese centers from January 2005to December 2021 were retrospectively analyzed.The patients were treated with rituximab-based chemotherapy before transplantation,and the effects of clinical characteristics,treatment regimens and biological indicators on overall survival(OS) and progression-free survival(PFS) were observed.Results:Among the 85 patients,there were 65 males and 20females with a median age of 53(34-68) years,11 cases of blastic and pleomorphic type and 74 cases of classical type.According to Ann Arbor staging,5 cases were in stage Ⅰ-Ⅱ and 80 cases were in stage Ⅲ-Ⅳ.There were 18 cases with Ki-67≥50%,29 cases with B symptoms,and 68 cases with external involvement.High-dose cytarabine was used in 56patients,and 31 patients were in a relapsed/refractory state.With a median follow-up of 51(12-202) months after ASCT,the estimated 5-year PFS rate was(68.4±6.0)%,and the estimated 5-year OS rate was(87.4±4.6) %.Multivariate Cox regression analysis showed that MIPI-c intermediate-high/high risk(HR=4.461,95%CI:1.822-10.918,P=0.001) and no maintenance treatment(HR=3.127,95%CI:1.398-6.991,P=0.005) were independent adverse prognostic factors for PFS,and relapsed and refractory state[HR=4.727,95%CI:1.005-22.234,P=0.049] were independent adverse prognostic factors for OS.Conclusion:ASCT consolidation therapy plays an important role in improving PFS and OS of MCL patients with young age and good general condition,especially for those with MIPI-c low/low-intermediate risk,receiving maintenance therapy with new drugs after ASCT,and non-relapsed/refractory state.更多还原