Mabed M, Al-Kgodary T
Hematology and Medical Oncology Unit, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Bone Marrow Transplant. 2006 Apr;37(8):739-43. doi: 10.1038/sj.bmt.1705314.
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.
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。