造血干细胞移植治疗NK/T细胞淋巴瘤的临床进展

Advances in hematopoietic stem cell transplantation of NK/T cell lymphoma

摘要:

NK/T细胞淋巴瘤是结外爱泼斯坦-巴尔病毒相关的恶性肿瘤，表现为肿瘤局部坏死、血管损伤和破坏、细胞毒性表型及EBV感染。NK/T细胞淋巴瘤在亚洲、南美洲更为常见，占非霍奇金淋巴瘤的5％～10％，5年总生存率不到20％，对化疗反应不佳且容易复发，急迫需要寻求新的治疗方法。造血干细胞移植（HSCT）通过重建免疫系统及异基因造血干细胞移植的移植物抗肿瘤效应，对晚期及难治/复发病例治疗有特殊的优势。随着基础及临床研究的积累，HSCT在治疗NK/T细胞淋巴瘤上有了一定的进展。该文主要围绕NK/T细胞淋巴瘤的HSCT的时机、选择方式及围术期处理进行综述，重点阐述目前该领域的进展，以期指导临床。

Abstract:

NK/T cell lymphoma is a kind of extranodal Epstein-Barr virus (EBV) -related malignant tumor, which is characterized by local tumor necrosis, vascular injury and destruction, cytotoxic phenotype and EBV infection. NK/T cell lymphoma is more common in Asia and South America than other place and accounts for 5% to 10% of non-Hodgkin lymphoma, with less than 20% of 5-year overall survival rate (OS), as well as poor in response to chemotherapy and prone to recurrence. It is urgent to search for new treatment methods. By rebuilding the immune system, hematopoietic stem cell transplantation (HSCT) owns a particularly advantage in treating NK/T cell lymphoma, meanwhile, allogeneic hematopoietic stem cell transplantation (allo-HSCT) even has a graft anti-tumor (GVL) effect to defeat tumor cells. With the accumulation in both basic and clinical research, HSCT has made certain progress in the treatment of NK/T cell lymphoma. This review provides a brief overview of HSCT and its perioperative management in NK/T cell lymphoma, highlights recent advances and discusses future challenges.