Clinical analysis of adoptive immunotherapy after autologous peripheral blood stem cell transplantation in B lymphocyte malignant lymphoma

The purpose of this study was to investigate the efficacy of treatment with autologous peripheral blood stem cell transplantation (APBSCT) combined with adoptive immunotherapy in B lymphocyte malignant lymphoma (ML). According to receiving adoptive Immunotherapy or not after APBSCT, the patients were divided into two groups: treatment group and control group. 110 case patients [78 cases with non-Hodgkin’s lymphoma (NHL), 32 cases with Hodgkin’s lymphoma (HL)] from January 2000 to December 2009 were enrolled in a treatment group, while 74 cases (54 NHL, 22 HL) from January 1995 to December 1999 were taken as control. All of patients were treated sequentially with chemotherapy regimens for 6 courses. After that, all the patients received APBSCT. After hematopoietic reconstruction, the patients in treatment group were given six courses adoptive immunotherapy (rhIL-2 100 WU/day for 10 days monthly for each course) while the patients as control group were not given immunotherapy. All patients were followed-up for more than 5 years. The result showed that: 1. One patient in treatment group died for liver failure in three months, and one died for cerebral hemorrhage in two months; the other patients all achieved hematopoietic reconstruction. 2. Follow-up for 1, 3, 5 years, the disease free survival (DFS) rate in treatment group was 97.3%, 93.6% and 87.3%, respectively, while in control group was 91.9%, 73.0% and 64.9%, respectively. Follow-up for 3 and 5 years, there is significant difference in DFS between two groups (P<0.01). The DFS rate for 1, 3 and 5 year in treatment group of the patients in stage I/II and III/IV were 100%, 100%, 91.7% and 96.5%, 91.9%, 86.0%, respectively, while in control group was 100%, 93.3%, 86.7 and 89.8%, 67.8%, 59.3% respectively. There is significant difference of DFS for III/IV stage patients between two groups after following up for 3, 5 years (P<0.01). 3. The DFS rate for 1, 3 and 5 year in HL patients is 100%, 93.8% and 84.4% in treatment group, while that is 100%, 72.7% and 59.1% in control group, respectively. Follow-up for 3 and 5 years, there is significant difference of DFS in HL patients between two groups (P<0.05). The DFS rate for 1, 3 and 5 year in stage I/II HL patients is 100%, 100% and 88.9% in treatment group, while that is 100%, 100% and 80.0% in control group. The DFS for 1, 3 and 5 year in HL patients in stage III/IV is 100%, 91.3% and 82.6%, while that is 94.1%, 64.7% and 52.9% in control group, respectively. There is significant difference of DFS in III/IV stage patients between HL of two groups after following up for 3, 5 years (P<0.05). 4. The DFS rate for 1, 3 and 5 year in NHL patients is 96.2%, 93.6% and 88.5 in treatment group, while that is 90.4%, 73.1% and 65.4% in control group, respectively. Follow-up for 3 and 5 years, there is significant difference of DFS in NHL patients between two groups (P<0.01). The DFS rate for 1, 3 and 5 year in NHL patients in stage I/II is 100%, 100% and 93.3.9% in treatment group, while that is 100%, 90% and 90.0% in control group. The DFS for 1, 3 and 5 year in NHL patients in stage III/IV is 95.2%, 92.1% and 87.3%, while that is 88.1%, 69.0% and 59.5% in control group, respectively. There is significant difference of DFS in NHL patients in III/IV stage between two groups after following up for 3, 5 years (P<0.05). Conclusion: The results are satisfactory for patients with B lymphocyte ML and treating with adoptive immunotherapy after APBSCT, especially the patients in stage III/VI.