Lin Thomas S, Copelan Edward A
Division of Hematology and Oncology, Ohio State University, 320 West 10th Avenue, Columbus, OH 43210, USA.
Curr Hematol Rep. 2003 Jul;2(4):310-5.
Autologous stem cell transplantation (ASCT) is the only curative option for many patients with relapsed or refractory non-Hodgkin's lymphoma. ASCT achieves long-term survival in up to 50% of patients with chemotherapy-sensitive relapsed diffuse large cell lymphoma (DLCL), and prospective randomized studies have documented the superiority of ASCT over salvage chemotherapy in patients with relapsed DLCL However, the role of ASCT as an upfront therapy for patients with high-risk DLCL remains unclear, and prospective randomized studies have yielded mixed results. In addition, ASCT may not be curative in follicle center or mantle cell lymphoma, although longer follow-up may identify a subset of patients with prolonged survival. Ongoing clinical trials are studying the use of monoclonal antibodies, such as rituximab and iodine 131I-tositumomab, in ASCT regimens to purge tumor cells in vivo and improve long-term outcome in follicle center and mantle cell lymphoma.
自体干细胞移植（ASCT）是许多复发或难治性非霍奇金淋巴瘤患者的唯一治愈选择。对于化疗敏感的复发弥漫大B细胞淋巴瘤（DLCL）患者，ASCT可使高达50%的患者获得长期生存，前瞻性随机研究已证明ASCT在复发DLCL患者中优于挽救性化疗。然而，ASCT作为高危DLCL患者初始治疗的作用仍不明确，前瞻性随机研究结果不一。此外，尽管更长时间的随访可能会发现一部分生存时间延长的患者，但ASCT可能无法治愈滤泡中心淋巴瘤或套细胞淋巴瘤。正在进行的临床试验正在研究在ASCT方案中使用单克隆抗体，如利妥昔单抗和碘131I-托西莫单抗，以在体内清除肿瘤细胞并改善滤泡中心淋巴瘤和套细胞淋巴瘤的长期疗效。
