中国霍奇金淋巴瘤的诊断与治疗指南(2022年版)

  目的  探讨新药时代自体造血干细胞移植（autologous hematopoietic stem cell transplantation，ASCT）治疗复发或难治性（relapse or refractory，R/R）经典型霍奇金淋巴瘤（classical Hodgkin's lymphoma，cHL）的疗效。  方法  回顾性分析2010年1月至2022年12月在中国医学科学院血液病医院诊治的56例挽救治疗敏感、序贯ASCT治疗的R/R cHL患者，根据挽救治疗是否包含维布妥昔单抗（brentuximab vedotin，BV）或程序性死亡受体1（programmed death-1，PD-1）抑制剂分为新药组32例和非新药组24例，分析两组患者的临床特征及疗效，使用Kaplan-Meier法进行生存分析。  结果  56例患者中男性35例，女性21例，中位移植年龄29（11～55）岁。中位随访时间56（ 2～137）个月，移植后预期5年总生存（overall survival，OS）率和无进展生存（progression- free survival，PFS）率分别为94.3%和75.8%。新药组患者的5年PFS更优（90.1% vs. 59.1%，HR=0.23，95%CI：0.07～0.71，P=0.011），但OS差异无统计学意义（93.5% vs. 95.5%，HR=1.2，95%CI：0.14～10.34，P=0.873）。  结论  对于挽救治疗敏感的R/R cHL患者，ASCT仍然是标准的巩固治疗策略。新药在移植前、后的应用可进一步提高ASCT治疗R/R cHL患者的生存。

Hodgkin lymphoma: 2023 update on diagnosis,risk-stratification,and management

  Objective   Evaluating the efficacy and outcomes of autologous hematopoietic stem cell transplantation (ASCT) for patients with relapsed or refractory (R/R) classical Hodgkin's lymphoma (cHL) using novel agents.   Methods   Fifty-six patients diagnosed with R/R cHL exhibiting sensitivity to salvage therapy underwent ASCT at the Institute of Hematology & Blood Diseases Hospital from January 2010 to December 2022 participated in our review. The patients were assigned into two groups based on whether they received brentuximab vedotin (BV) or programmed death-1 (PD-1) inhibitors pre-transplantation: the novel agent group (n=32) and no novel agent group (n=24). Their characteristics and outcomes were analyzed retrospectively, and survival was assessed using Kaplan-Meier method.   Results  Median age of transplantation for 56 patients with R/R cHL was 29 years (range: 11-55 years), with 35 male and 21 female patients. With a median follow-up of 56 (2-137) months, the 5-year overall survival (OS) and progression-free survival (PFS) rates post-transplantation were estimated to be 94.3% and 75.8%, respectively. The 5-year PFS was superior for patients using novel agents pre-transplantation (90.1% vs. 59.1%, hazard ratio [HR]=0.23, 95% confidence intervals [CI]: 0.07-0.71, P=0.011) without a statistically significant difference in OS (93.5% vs. 95.5%, HR=1.2, 95%CI: 0.14–10.34, P=0.873).   Conclusions   ASCT remains the standard consolidation therapy for patients with salvage-sensitive R/R cHL. The incorporation of novel agents pre-and post-transplantation enhances the outcomes of patients who have undergone ASCT for R/R cHL.