The Expression Of TIA-1 And CD3ε In Nasal T/NK Cell Lymphoma And The Study Of Autologous Hematopoiectic Stem Cell Transplantation Combined With High Dose Radiotherapy/Chemotherapy For Nasal T/NK Cell Lymphoma

The nasal T/NK cell lymphoma is an uncommon extranodal malignant lymphoma with special morphologic, immunophenotyping and biology. Clinically, patients present with ulcerative destructive lesions of the midline face. This neoplasm is common in Asia and South America, but rare in Europe, and more common in male. A relatively high incidence of nasal T/NK cell lymphoma has been observed in China.In southwest, the nasal lymphoma comprises about 20% of all malignant lymphoma. CD45RO (+),CD3e (+),CD2 (+) 及 CD3(-) for T cell and CD56 (+),CD3e(+),CD3(-) for NK cell. TIA-1 is expressing in both of them. The lymphoma is associated with EBV. Patients with nasal lymphoma seemed to have a poor prognosis with chemotherapy, especially for the advanced diseases. Only case reports of AHSCT and high-dose chemotherapy can be seen in Hong Kong and Japan.Objective: 1 To evaluat the immunotype, the association of EBV and the nasal T/NK cell lymphoma. 2 To evaluation the prognosis and the role of patients with AHSCT.Metholds:1 TIA-1 and CD3 e were measured by IHC onparaffin-embedded slices in 36 cases of nasal T/NK cell lymphoma patients with 16 cases of them received AHSCT. 2 40 cases of nasal T/NK cell lymphoma received CHOP and COP chemotherapy and radiotherapy (40~65Gy) with 15 cases received a IFN. 3 Among them, 4 cases were treated with high-dose chemotherapy with ABMT and 16 cases were received with APBSCT. In the latter , the APBSCs were mobilized by CE or CHO plus granulocyte-colony stimulating factor(G-CSF) and/or granulocyte-macrophage colony stimulating factor (GM-CSF) 10 u g/kg/d. Pretreatment, which the patients were received with high-dose chemotherapy regimen, BEAM (BCNU 300 mg/m2 + Vp-16 600 mg/m2 + Ara-C 2g/ m2 + Mel 140mg/m2) or TBI (8Gy) + Mel 140mg/m2 ?Vp-16 200mg盇ra-C lg/ m2 . 4 Survival analysis was done by the Kaplan-Meier method and log-rank test. Multivariate analysis was carried out using Cox proportional hazard model.Results: 1 IHC result: The positive rate of TIA-1 and CDS ?in the 36 cases were 72. 22%(26/36) and 69. 44%(25/36). 2 Survival rate and survive: The patients of control group were flowed up for 18~ 180 months and 14~141 months for patients received AHSCT, a median of 83 months and 71 months. The 1, 2, 3, 5-year survival rates of control group (CHOP, COP regimens) were 67.32%, 48.83%, 40.69%, 37.98% and 94. 12%, 94. 12%, 87. 39%, 87. 39% for patients received AHSCT. And 7 of 20 patients received AHSCT developed relapse . To the I ~ IIpatients received AHSCT, the 2, 3, 5-year survival rates were 90. 00%, 77. 14% and 77. 14%, 53. 57%, 50. 00% and 42. 86% for patients of control group. And to the III桰V patients received AHSCT , the 2, 3, 5-year survival ratesn 8 JS. & 44 Kwere 83.33%, 33.33%, 16.67% and 16.67% for patients of control group. There was significant difference of survival rate between the two groups. 3 Multivariate analysis showed that AHSCT, B symptom and stage were independent prognostic factors.Conclusion: 1 A high percentage of these tumor cells express TIA-1 and CD3e in nasal T/NK cell lymphoma. 2 The survival rate of patients received AHSCT was higher than that of routine chemotherapy, especially for the patients with B symptom and terminal stage.