Oncology Frontier: What is the current state-of-art for transplantation paradigms in peripheral T-cell lymphomas?

　　《肿瘤瞭望》：造血干细胞移植在外周T细胞淋巴瘤中的治疗地位如何？

　　Dr Piccaluga: Based on the latest data， we can see two different scenarios. Autologous stem cell transplantation (with stem cells collected from the patient， not from relatives or voluntary donors) is currently recommended in all advanced stage disease for all subtypes of peripheral T-cell lymphomas， or in early stages with additional risk factors where the International Prognostic Index is unfavorable for that patient. This is recommended in the first-line after chemotherapy because recent data indicated that amongst patients receiving transplantation， roughly 50-60% can be cured with this approach. Not all patients can be treated with autologous transplantation because they either have poor performance status (maybe they are elderly) or their disease is progressing or relapsing early so there isn’t time to go to transplantation. On the other hand， you have allogeneic stem cell transplantation， so the transplant is performed with stem cells from other people， not from the patient themselves. This is somewhat effective but， so far， we recommend including patients in clinical trials when you perform allogeneic transplantation， or to reserve allogeneic transplantation for relapsed patients.

　　Piccaluga教授：自体干细胞移植可用于外周T细胞淋巴瘤所有亚型的晚期患者，以及具有其他危险因素的、预后指数不佳的早期患者。最近的研究显示，50%~60%的外周T细胞淋巴瘤患者，其中包括接受肾移植的患者，可以通过这种方法治愈。然而，并非所有的患者都可以采用自体干细胞移植治疗，有的可能由于患者一般情况不佳，有的可能疾病进展迅速或者复发，来不及进行移植。不过另一方面，异基因造血干细胞移植在一定程度上也是有效的，目前仍处于临床试验中。