高效大剂量化疗联合CD34+选择的外周血干细胞移植治疗皮肤受累的鼻NK/T细胞淋巴瘤患者

Effective high-dose chemotherapy combined with CD34+-selected peripheral blood stem cell transplantation in a patient with cutaneous involvement of nasal NK/T-cell lymphoma.

作者信息

Koizumi Kazuki, Fujimoto Katsuya, Haseyama Yoshihito, Endo Tomoyuki, Nishio Mitsufumi, Yokota Kouichi, Itoh Tomoo, Sawada Ken-ichi, Koike Takao

机构信息

Department of Internal Medicine II, Hokkaido University School of Medicine, Sapporo, Japan.

出版信息

Eur J Haematol. 2004 Feb;72(2):140-4. doi: 10.1046/j.0902-4441.2003.00170.x.

DOI:10.1046/j.0902-4441.2003.00170.x

PMID:14962252

Abstract

The prognosis of nasal natural killer (NK)/T-cell lymphoma with cutaneous involvement especially is morbid despite intensive chemotherapy and radiotherapy. We treated a 52-yr-old Japanese woman with cutaneous dissemination of nasal NK/T-cell lymphoma. Six cycles of chemotherapy, irradiation to skin lesion were administered and complete remission (CR) was attained. High-dose chemotherapy (HDC; etoposide 750 mg/m(2) x 2 d, cyclophosphamide 60 mg/kg x 2 d, total body irradiation 12 Gy two daily fractions x 3 d) followed by CD34(+)-selected autologous peripheral blood stem cell transplantation (CD34(+)-APBSCT) was then prescribed. Complete remission (CR) was obtained and she has been free of disease for 34 months since CD34(+)-APBSCT. We suggest that marrow-ablative chemotherapy facilitated by autologous stem cell transplantation should be considered part of the primary therapy for subjects with a poor prognosis for nasal NK/T-cell lymphoma with cutaneous involvement.

摘要

鼻型自然杀伤（NK）/T细胞淋巴瘤若伴有皮肤受累，即便接受强化化疗和放疗，预后依然不佳。我们治疗了一名52岁的日本女性，其鼻型NK/T细胞淋巴瘤出现皮肤播散。给予六个周期的化疗及皮肤病变部位放疗后，患者达到完全缓解（CR）。随后进行了大剂量化疗（HDC；依托泊苷750 mg/m²×2天，环磷酰胺60 mg/kg×2天，全身照射12 Gy，分两次每日剂量，共3天），接着进行CD34⁺选择的自体外周血干细胞移植（CD34⁺-APBSCT）。患者获得完全缓解（CR），自CD34⁺-APBSCT后已无病生存34个月。我们建议，对于伴有皮肤受累的鼻型NK/T细胞淋巴瘤预后较差的患者，自体干细胞移植辅助下的清髓性化疗应被视为初始治疗的一部分。