Pavone V, Gaudio F, Guarini A, Perrone T, Zonno A, Curci P, Liso V
Haematology, University of Bari, Medical School, Policlinico Bari, Italy.
Bone Marrow Transplant. 2002 Feb;29(4):285-90. doi: 10.1038/sj.bmt.1703364.
Our study analyzes the mobilization of hematopoietic stem cells after two chemotherapeutic regimens in non-Hodgkin's lymphoma (NHL) patients. The study included 72 patients with NHL (42 follicular and 30 large cells). The mean age was 37 years (range 17-60). Sixty-four patients (88.9%) had stage III-IV disease. Forty-eight patients (66.7%) had bone marrow involvement. Systemic B symptoms were present in 42 patients (58.3%). Mobilization chemotherapy regimens were randomly assigned as DHAP in 38 patients (52.7%) or cyclophosphamide (CPM) (5 g/m(2)) in 34 (47.2%) and the results of 132 procedures were analyzed. At the time of PBSC mobilization, 46 patients (63.9%) were considered to be responsive (complete remission, partial remission or sensitive relapse) and 26 (36.1%) not responsive (refractory relapse or refractory to therapy). Pre-apheresis CD34+ blood cell count and number of previous chemotherapy treatments were used to predict the total number of CD34+ cells in the apheresis product. The mobilizing regimens (CPM or DHAP) were similar in achieving the threshold CD34+ cell yield, for optimal engraftment. Since DHAP was very effective as salvage treatment, we suggest using DHAP as a mobilizing regimen in patients with active residual lymphoma at the time of stem cell collection.
我们的研究分析了非霍奇金淋巴瘤（NHL）患者在两种化疗方案后造血干细胞的动员情况。该研究纳入了72例NHL患者（42例滤泡型和30例大细胞型）。平均年龄为37岁（范围17 - 60岁）。64例患者（88.9%）处于Ⅲ - Ⅳ期疾病。48例患者（66.7%）有骨髓受累。42例患者（58.3%）有全身B症状。动员化疗方案随机分配，38例患者（52.7%）接受DHAP方案，34例患者（47.2%）接受环磷酰胺（CPM）（5 g/m²）方案，并分析了132次操作的结果。在进行外周血干细胞动员时，46例患者（63.9%）被认为有反应（完全缓解、部分缓解或敏感复发），26例患者（36.1%）无反应（难治性复发或对治疗耐药）。采集前CD34⁺血细胞计数和既往化疗次数用于预测采集产物中CD34⁺细胞的总数。为实现最佳植入，CPM或DHAP动员方案在达到阈值CD34⁺细胞产量方面相似。由于DHAP作为挽救治疗非常有效，我们建议在干细胞采集时对有活动性残留淋巴瘤的患者使用DHAP作为动员方案。
