Yusuf R Z, Dey B, Yeap B Y, McAfee S, Attar E, Sepe P S, Dube C, Spitzer T R, Ballen K K
Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA.
Bone Marrow Transplant. 2009 Jan;43(1):37-42. doi: 10.1038/bmt.2008.298. Epub 2008 Sep 15.
Autologous SCT is a potentially curative procedure for patients with relapsed lymphoma (NHL). We analyzed the outcomes of 34 patients > or =60 years old, including eight patients > or =70 years old, who received BU and CY and SCT for NHL. Patients received BU 0.8 mg/kg i.v. (n=25) or 1 mg/kg p.o. (n=9) q 6 h x 14 doses and CY 60 mg/kg i.v. q day x 2 days. The median age was 66 (range, 60-78) years. Twenty-two patients had large cell, 10 follicular and two-mantle cell lymphoma. Fifteen patients were in a second or greater CR and 19 patients were in a PR. The median days to ANC >500/microl and platelet count >50,000/microl were 10 and 13 days respectively. The 100-day transplant-related mortality was 0%. Toxicities included interstitial lung disease (n=2), seizures in a patient with CNS lymphoma (n=1), mild veno-occlusive disease (n=2), and transient atrial fibrillation (n=4). With a median follow-up of 40 months, the 2-year overall survival and PFS were 67 and 54% respectively. BU/CY is a well-tolerated conditioning regimen for older patients with NHL. Age alone should not be used as an exclusion criterion for autologous SCT.
自体干细胞移植（SCT）对于复发淋巴瘤（非霍奇金淋巴瘤，NHL）患者而言是一种具有潜在治愈可能的治疗方法。我们分析了34例年龄≥60岁的患者的治疗结果，其中包括8例年龄≥70岁的患者，这些患者因NHL接受了白消安（BU）、环磷酰胺（CY）及SCT治疗。患者接受静脉注射白消安0.8mg/kg（n = 25）或口服白消安1mg/kg（n = 9），每6小时1次，共14剂，以及静脉注射环磷酰胺60mg/kg，每日1次，共2日。中位年龄为66岁（范围60 - 78岁）。22例患者为大细胞淋巴瘤，10例为滤泡性淋巴瘤，2例为套细胞淋巴瘤。15例患者处于第二次或更高级别的完全缓解期，19例患者处于部分缓解期。中性粒细胞计数>500/μl和血小板计数>50,000/μl的中位天数分别为10天和13天。100天的移植相关死亡率为0%。毒性反应包括间质性肺疾病（n = 2）、1例中枢神经系统淋巴瘤患者发生癫痫（n = 1）、轻度静脉闭塞性疾病（n = 2）和短暂性心房颤动（n = 4）。中位随访40个月时，2年总生存率和无进展生存率分别为67%和54%。对于老年NHL患者而言，BU/CY是一种耐受性良好的预处理方案。不应仅以年龄作为自体SCT的排除标准。
