外周T细胞淋巴瘤（PTCLs）是罕见且侵袭性的肿瘤，其最佳治疗方法尚不确定。本研究调查了CD34+选择性清除后，高剂量化疗（HDT）联合自体干细胞移植（ASCT）的临床疗效，纳入67例达到缓解状态并接受HDT/ASCT的PTCL患者进行回顾性分析。选择性清除CD34+细胞使用CliniMACS®进行（德国Bergisch Gladbach市Miltenyi Biotec公司）。评估了生存情况、移植、淋巴细胞亚群和病毒感染情况。与未清除的自体移植相比，选择性清除CD34+的自体移植显著提高了总生存率（满5年，73.3%对37.8%）和无病生存率（满5年，73.8%对33.4%）。清除组的复发累积发生率也较低（31.5%对73.3%）。亚组分析显示接受清除自体移植的高风险组获得了显著的生存益处。淋巴细胞亚群分析显示，在ASCT后，清除组的NK细胞计数增加。较高的ASCT后淋巴细胞与单核细胞比值（LMR）与改善的总生存率和无病生存率相关。CD34+选择性清除在接受HDT/ASCT的PTCL患者中改善了生存疗效，减少了复发风险。该程序增加了NK细胞计数和ASCT后的LMR。CD34+选择性清除可能减少自体移植肿瘤细胞污染，并增强T细胞淋巴瘤的疗效。 版权信息：©2023国际细胞与基因治疗学会。Elsevier Inc.出版，保留所有权利。

Peripheral T-cell lymphomas (PTCLs) are rare and aggressive tumors with uncertain optimal treatment. This study investigated the clinical outcomes of high-dose chemotherapy (HDT) followed by autologous stem cell transplantation (ASCT) after CD34+ selective purging in PTCL patients.Retrospective analysis included 67 PTCL patients who achieved remission and underwent HDT/ASCT. CD34+ selective purging was performed using CliniMACS® (Miltenyi Biotec, Bergisch Gladbach, Germany). Survival outcomes, engraftment, lymphocyte subsets and viral infections were evaluated.CD34+ selective purged autografts were associated with significantly improved overall survival (OS) and disease-free survival (DFS) compared with unpurged autografts (5-year OS, 73.3% versus 37.8%, 5-year DFS, 73.8% versus 33.4%). The cumulative incidence of relapse was also lower in the purged group (31.5% versus 73.3%). Subgroup analysis revealed significant survival benefits in the high-risk group receiving purged autografts. Lymphocyte subset analysis showed increased natural killer (NK) cell counts in the purged group after ASCT. Higher post-ASCT lymphocyte-to-monocyte ratio (LMR) was associated with improved OS and DFS.CD34+ selective purging in PTCL patients undergoing HDT/ASCT improved survival outcomes and reduced relapse risk. The procedure increased NK cell counts and post-ASCT LMR. CD34+ selective purging may minimize autograft tumor cell contamination and enhance efficacy in T-cell lymphomas.Copyright © 2023 International Society for Cell & Gene Therapy. Published by Elsevier Inc. All rights reserved.