Objective: This study aimed to compare the efficacy and safety of cladribine, smustine, etoposide, cyclophosphamide, and cytarabine (C+SCAV) and smustine, etoposide, cytarabine, and melphalan (SEAM) conditioning regimens in autologous stem cell transplantation (auto-HSCT) for non-Hodgkin's lymphoma (NHL) . Methods: A retrospective analysis was conducted on 61 NHL patients who received auto-HSCT in the Department of Hematology, the First Affiliated Hospital of Suzhou University, from March 2018 to May 2021. The C + SCAV group and SEAM group had 19 and 42 patients, respectively. Results: ① Among the 61 patients with NHL, 37 were male and 24 were female. The median age was 48 (21-66) years old. There were 19 cases in the C+SCAV group and 42 cases in the SEAM group. There was no significant difference in the baseline characteristics between the two groups (P>0.05) . ② The median time to neutrophil and platelet engraftment in the C+SCAV cohort were 10 (8-15) days and 13 (9-22) days, respectively, which does not differ from the SEAM group (P=0.103, P=0.403) . ③ No differences existed between the two groups in terms of survival. The 1-year progression-free survival (PFS) was (76.5±10.3) % for patients receiving C+SCAV and (78.4±6.8) % for those who received SEAM (P=0.841) . The 1-year overall survival was 100.0% for the C+SCAV group and 95.2±3.3% for the SEAM group (P=0.339) . ④The 1-year PFS of patients with complete remission in the C+SCAV group was similar to those who in the SEAM group [ (92.3±7.4) % vs (82.5±7.2) %, P=0.406]. ⑤ The incidence of non-hematological serious adverse events (≥ grade 3) in the C+SCAV group and SEAM group were 10.5% (2/19) and 40.5% (17/42) (P=0.013) , the incidence of severe mucositis was 5.3% (1/19) and 31.0% (13/42) (P=0.015) , and the incidence of severe infection (≥ grade 3) was 10.5% (2/19) and 19.0% (8/42) (P=0.389) , respectively. Conclusion: C + SCAV conditioning regimen appeared to be no different from the SEAM regimen in terms of survival. It can lower the incidence of SAE and does not increase the risk of severe infection. As a result, it can be used as an alternative conditioning regimen for lymphoma patients undergoing auto-HSCT.
目的： 比较C+SCAV（克拉屈滨+司莫司汀+环磷酰胺+阿糖胞苷+依托泊苷）和SEAM（司莫司汀+依托泊苷+阿糖胞苷+美法仑）两种预处理方案在非霍奇金淋巴瘤（NHL）患者自体造血干细胞移植（auto-HSCT）中的疗效与安全性。 方法： 对2018年3月至2021年5月期间在苏州大学附属第一医院血液科接受auto-HSCT的61例NHL患者进行回顾性分析。 结果： ①61例NHL患者中，男37例，女24例；中位年龄48（21~66）岁，C+SCAV方案组19例，SEAM方案组42例，两组在基线特征方面差异无统计学意义（P>0.05）。②C+SCAV组、SEAM组中性粒细胞植入中位时间分别为10（8~15）d、9（7~16）d（P=0.103），血小板植入的中位时间分别为13（9~22）d、12（7~30）d（P=0.403），差异均无统计学意义。③C+SCAV组、SEAM组移植后1年无进展生存（PFS）率分别为（76.5±10.3）%、（78.4±6.8）%（P=0.841），总生存（OS）率分别为100.0%、（95.2±3.3）%（P=0.339）。④对于移植前达完全缓解（CR）状态的患者，C+SCAV组、SEAM组移植后1年PFS率分别为（92.3±7.4）%、（82.5±7.2）%（P=0.406）。⑤C+SCAV组、SEAM组非血液系统严重不良反应（≥3级）发生率分别为10.5%（2/19）、40.5%（17/42）（P=0.013），严重黏膜炎的发生率分别为5.3%（1/19）、31.0%（13/42）（P=0.015），严重感染（≥3级）的发生率分别为10.5%（2/19）、19.0%（8/42）（P=0.389）。 结论： 采用C+SCAV预处理方案auto-HSCT治疗NHL患者可获得与SEAM预处理方案相似的移植后1年后生存率，非血液系统严重不良反应发生率较低且不会增加严重感染的风险。.
Keywords: Autologous stem cell transplantation; Cladribine; Conditioning regimen; Non-Hodgkin lymphoma.