Straus D J, Wong G Y, Liu J, Oppenberg J, Filippa D A, Gold J W, Offit K, Clarkson B D
Division of Hematologic Oncology, Memorial Sloan Kettering Cancer Center, New York, New York 10021.
Am J Med. 1991 Mar;90(3):328-37.
Small non-cleaved-cell lymphoma (SNCL) "Burkitt's type," a rapidly growing lymphoma, has been rare among adults in the United States, but has greatly increased in incidence with the acquired immunodeficiency syndrome epidemic. This report details the results of treatment of adult SNCL with a series of protocols originally designed for the treatment of acute lymphoblastic leukemia (ALL).
Between July 1973 and May 1987, 29 adults with newly diagnosed SNCL were treated at Memorial Hospital with intensive chemotherapy originally designed for ALL: the cyclophosphamide L-2, L-10, L-17, and L-20 protocols. Nine patients had positive serologies for human immunodeficiency virus (HIV) infection. One patient with all measurable disease resected was not evaluable for response.
Sixteen of 28 evaluable patients (57%) achieved a complete remission with treatment. With follow-up as long as 153 months (median, 47 months), 50% of all patients and 59% of patients with negative or unknown HIV serologies have survived and are probably cured. Patients with an initial serum lactic acid dehydrogenase (LDH) level of greater than 500 U/L had a significantly shortened survival as compared with those with a lower serum LDH. Other pretreatment patient characteristics associated with a shortened survival of borderline statistical significance were high National Cancer Institute stage (C, D) and bone marrow involvement. These results are similar to those for ALL and lymphoblastic lymphoma and are comparable to those for American SNCL in the literature.
Approximately one half of adults with SNCL are curable with intensive chemotherapy. More intensive chemotherapy with hematopoietic growth factor and/or autologous bone marrow or peripheral stem cell support may increase curability.
小无裂细胞淋巴瘤（SNCL）“伯基特型”是一种生长迅速的淋巴瘤，在美国成年人中较为罕见，但随着获得性免疫缺陷综合征的流行，其发病率大幅上升。本报告详细介绍了采用一系列最初设计用于治疗急性淋巴细胞白血病（ALL）的方案治疗成人SNCL的结果。
1973年7月至1987年5月期间，纪念医院对29例新诊断的SNCL成人患者采用最初设计用于ALL的强化化疗进行治疗：环磷酰胺L-2、L-10、L-17和L-20方案。9例患者人类免疫缺陷病毒（HIV）感染血清学检查呈阳性。1例所有可测量病灶均已切除的患者无法评估疗效。
28例可评估患者中有16例（57%）经治疗后达到完全缓解。随访时间长达153个月（中位数为47个月），所有患者中有50%以及HIV血清学检查阴性或未知的患者中有59%存活且可能已治愈。初始血清乳酸脱氢酶（LDH）水平大于500 U/L的患者与血清LDH水平较低的患者相比，生存期明显缩短。其他与生存期缩短相关且具有临界统计学意义的预处理患者特征包括美国国立癌症研究所分期较高（C、D期）和骨髓受累。这些结果与ALL和淋巴母细胞淋巴瘤的结果相似，且与文献中美国SNCL的结果相当。
约一半的成人SNCL患者可通过强化化疗治愈。采用造血生长因子和/或自体骨髓或外周干细胞支持的更强化化疗可能会提高治愈率。
