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环磷酰胺、依托泊苷和顺铂联合非冷冻保存的自体外周血干细胞移植解救难治性或复发性非霍奇金淋巴瘤患者。

Cyclophosphamide, etoposide and carboplatine plus non-cryopreserved autologous peripheral blood stem cell transplantation rescue for patients with refractory or relapsed non-Hodgkin's lymphomas.

作者信息

Mabed M, Al-Kgodary T

机构信息

Hematology and Medical Oncology Unit, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

出版信息

Bone Marrow Transplant. 2006 Apr;37(8):739-43. doi: 10.1038/sj.bmt.1705314.

DOI:10.1038/sj.bmt.1705314
PMID:16501587
Abstract

A simplified schedule of high-dose chemotherapy consisting of cyclophosphamide (60 mg/kg/day for 2 days), etoposide (15 mg/kg/day for 2 days) and carboplatine (400 mg/m(2)/day for 2 days), together with autologous non-cryopreserved peripheral blood stem cells was used for treatment of relapsed (29 patients) and refractory (three patients) patients with non-Hodgkin's lymphoma (NHL). The use of such granulocyte colony-stimulating factor (G-CSF)-mobilized peripheral blood stem cells (PBSC) after high-dose myeloablative therapy resulted in a rapid, complete and sustained hematopoietic recovery. The median time to achieve an absolute neutrophil count greater than 0.5 x 10(9)/l was 12 days (range 8-17 days). The median time to self-sustained platelet count greater than 20 x 10(9)/l was 14 days (range 7-19 days). Fifteen of the 32 patients (49%) were alive and disease free at a median follow-up of 18 months (range 10-96 months) for all surviving patients. The estimated 2-year overall survival (OS) and disease free survival (DFS) for all patients were 50 and 43%, respectively. Twelve patients died of relapse or progressive disease, two patients died of infection and one patient died of cardiac cause. The median time to relapse was 12 months (5-27) from PBSC infusion. High-dose chemotherapy with short-duration chemotherapy and non-cryopreserved bone marrow (BM) is an effective and safe treatment modality for patients with relapsed or resistant NHL.

摘要

采用简化的大剂量化疗方案,该方案由环磷酰胺(60毫克/千克/天,共2天)、依托泊苷(15毫克/千克/天,共2天)和卡铂(400毫克/平方米/天,共2天)组成,并联合自体非冷冻保存的外周血干细胞,用于治疗复发(29例患者)和难治性(3例患者)非霍奇金淋巴瘤(NHL)患者。在大剂量清髓性化疗后使用这种粒细胞集落刺激因子(G-CSF)动员的外周血干细胞(PBSC),可实现快速、完全且持续的造血恢复。达到绝对中性粒细胞计数大于0.5×10⁹/升的中位时间为12天(范围8 - 17天)。血小板计数自我维持大于20×10⁹/升的中位时间为14天(范围7 - 19天)。32例患者中有15例(49%)在所有存活患者的中位随访18个月(范围10 - 96个月)时存活且无疾病。所有患者估计的2年总生存率(OS)和无病生存率(DFS)分别为50%和43%。12例患者死于复发或疾病进展,2例患者死于感染,1例患者死于心脏原因。自PBSC输注后至复发的中位时间为12个月(5 - 27个月)。短疗程化疗联合非冷冻保存骨髓的大剂量化疗是复发或耐药NHL患者一种有效且安全的治疗方式。

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