Nowrousian M R, Anders C H, Niederle N, Nagel-Hiemke M, Moritz T, Seeber S, Schmidt C G
West German Tumor Center, Department of Internal Medicine (Cancer Research), University of Essen, Department of Internal Medicine (Cancer Research), Hufelandstr. 55, 4300 Essen 1, FRG.
Ann Oncol. 1991 Jan;2 Suppl 1:25-30. doi: 10.1093/annonc/2.suppl_1.25.
The prognosis of patients with refractory or relapsed malignant lymphoma is poor. To improve the outcome of such patients, a therapeutic regimen of VIM +/- B (etoposide/ifosfamide plus mesna/methotrexate/ with or without bleomycin) was administered. Of 47 patients treated, 15 had relapsed following complete remission (CR) after first-line chemotherapy, 28 had failed to achieve CR with first-line therapy, and four failed to respond to multiple salvage regimens. All patients had received extensive prior chemotherapy, and 36 had received combinations containing doxorubicin. Eight patients had low-grade non-Hodgkin's lymphoma (NHL), 28 had high-grade NHL, and 11 patients had Hodgkin's disease. Overall response rate was 87%, with 45% CR and 42% partial remission (PR). Median relapse-free interval was 8 months in patients with CR and 6 months in those with PR. Of patients with CR, 43% were predicted to be without relapse at 2 years and 31% at 5 years. Median survival time for all patients treated with 14 months-22 months for those with CR and 10 months for those with PR. Probability of survival at 2 years was 30% in all patients, 50% in patients with CR, and 15% in those with PR. VIM +/- B appears to be effective against refractory or recurrent lymphoma, resulting in response in a large number of patients and long-term survival and possible cure in a small but significant number. Results indicate that VIM +/- B is particularly effective in patients with high-grade NHL who have responded suboptimally to primary therapy.
难治性或复发性恶性淋巴瘤患者的预后较差。为改善此类患者的治疗效果，采用了VIM+/-B（依托泊苷/异环磷酰胺加美司钠/甲氨蝶呤/有或无博来霉素）治疗方案。在接受治疗的47例患者中，15例在一线化疗完全缓解（CR）后复发，28例一线治疗未达到CR，4例对多种挽救方案无反应。所有患者均接受过广泛的前期化疗，36例接受过含阿霉素的联合化疗。8例为低度非霍奇金淋巴瘤（NHL），28例为高度NHL，11例为霍奇金病。总缓解率为87%，CR率为45%，部分缓解（PR）率为42%。CR患者的无复发生存期中位数为8个月，PR患者为6个月。CR患者中，预计2年无复发率为43%，5年为31%。所有接受治疗患者的中位生存时间为14个月 - CR患者为22个月，PR患者为10个月。所有患者2年生存率为30%，CR患者为50%，PR患者为15%。VIM+/-B似乎对难治性或复发性淋巴瘤有效，使大量患者产生反应，少数但数量可观的患者实现长期生存并可能治愈。结果表明，VIM+/-B对一线治疗反应欠佳的高度NHL患者特别有效。
