Schmitz N
Second Department of Internal Medicine, Christian-Albrechts-University, Kiel, Germany.
Anticancer Drugs. 2001 Jun;12 Suppl 2:S21-4.
Contamination of stem cell harvests with residual tumor cells is a significant problem hampering the success of autologous peripheral blood stem cell transplantation in non-Hodgkin's lymphoma (NHL). Techniques have therefore been introduced to attempt to remove these cells, either in vivo, prior to harvesting, or ex vivo, before reinfusion into the patient. Rituximab is a human-mouse chimeric anti-CD20 monoclonal antibody that has been administered to patients prior to stem cell harvesting, to purge the blood of residual malignant cells. Clinical studies have shown that rituximab is safe to use during stem cell mobilization since administration did not adversely affect the yield of CD34+ stem cells or the functional capability of these progenitors. Rituximab was also effective in purging stem cell harvests of malignant cells. Translocation of the bcl-2 gene was found in a significantly smaller proportion of stem cell harvests from patients who had received a purging infusion of rituximab than controls. Rituximab may also be useful as salvage therapy following post-transplant relapse or as maintenance therapy for patients in remission. Prospective randomized trials will ultimately define the role of rituximab in the autologous transplantation setting.
干细胞采集物被残留肿瘤细胞污染是一个严重问题，阻碍了非霍奇金淋巴瘤（NHL）自体外周血干细胞移植的成功。因此，已引入一些技术试图去除这些细胞，要么在采集前在体内进行，要么在回输到患者体内之前在体外进行。利妥昔单抗是一种人鼠嵌合抗CD20单克隆抗体，已在干细胞采集前给予患者，以清除血液中的残留恶性细胞。临床研究表明，利妥昔单抗在干细胞动员期间使用是安全的，因为给药不会对CD34+干细胞的产量或这些祖细胞的功能能力产生不利影响。利妥昔单抗在清除干细胞采集物中的恶性细胞方面也很有效。在接受利妥昔单抗清除输注的患者的干细胞采集物中，发现bcl-2基因易位的比例明显低于对照组。利妥昔单抗也可能作为移植后复发后的挽救治疗或缓解期患者的维持治疗有用。前瞻性随机试验最终将确定利妥昔单抗在自体移植环境中的作用。
