Imataki Osamu, Tamai Yotaro, Kawakami Kimihiro
Division of Hematology & Stem Cell Transplantation, Shizuoka Cancer Center.
Gan To Kagaku Ryoho. 2007 Oct;34(10):1629-32.
Standard salvage chemotherapy for refractory or relapsed malignant lymphoma has not been defined. The efficacy and feasibility of the ACES regimen, consisting of carboplatin at 100 mg/m(2) on day 1 to 4, etoposide at 80 mg/m(2) on day 1 to 4, high-dose Ara-C at 2 g/m(2) on day 5 and methylprednisolone at 500 mg/day for 5 days, for refractory or relapsed lymphoma were retrospectively reviewed in comparison with the ESHAP regimen. The subjects were 29 patients, including 7 aggressive follicular lymphomas, 16 large B cell lymphomas and 6 Hodgkin lymphomas. Characteristics of patients with ESHAP (19 cases) and the ACES (10 cases) group were as follows: male/female ratio, 10/9 and 3/7; median age, 49 (range, 31-72) and 54 (22-65); and initial clinical stage (I and II / III / IV), 5/8/6 and 1/1/8, respectively. Among the 29 patients, complete response was achieved in 68% (13/19) in ESHAP and 40% (4/10) in ACES.Progression-free survival and overall survival were 31.3% and 34.3%, respectively. Hematological toxicity was not significantly different between the two groups, and renal toxicity was significantly higher in ESHAP (52%) than ACES (0%). We concluded that the ACES regimen had a possibility of effective consolidation therapy for the elderly aiming to undergo autologous stem cell transplantation.
难治性或复发性恶性淋巴瘤的标准挽救性化疗方案尚未明确。回顾性比较了ACES方案(第1至4天给予卡铂100mg/m²、第1至4天给予依托泊苷80mg/m²、第5天给予大剂量阿糖胞苷2g/m²以及连续5天给予甲泼尼龙500mg/天)与ESHAP方案用于难治性或复发性淋巴瘤的疗效和可行性。研究对象为29例患者,包括7例侵袭性滤泡性淋巴瘤、16例大B细胞淋巴瘤和6例霍奇金淋巴瘤。ESHAP组(19例)和ACES组(10例)患者的特征如下:男女比例分别为10/9和3/7;中位年龄分别为49岁(范围31 - 72岁)和54岁(22 - 65岁);初始临床分期(I和II/III/IV期)分别为5/8/6和1/1/8。29例患者中,ESHAP组的完全缓解率为68%(13/19),ACES组为40%(4/10)。无进展生存期和总生存期分别为31.3%和34.3%。两组血液学毒性无显著差异,ESHAP组的肾毒性(52%)显著高于ACES组(0%)。我们得出结论,ACES方案有可能成为旨在接受自体干细胞移植的老年患者的有效巩固治疗方案。