自体骨髓移植用于滤泡性非霍奇金淋巴瘤早期巩固治疗的可行性

Feasibility of autologous bone marrow transplantation for early consolidation of follicular non-Hodgkin's lymphoma.

作者信息

Fouillard L, Gorin N C, Laporte J P, Douay L, Lopez M, Isnard F, Jouet J P, Walter M P, Morel P, Fenaux P

机构信息

Service des maladies du sang Hôpital Saint Antoine, Paris, France.

出版信息

Eur J Haematol. 1991 May;46(5):279-84. doi: 10.1111/j.1600-0609.1991.tb01539.x.

DOI:10.1111/j.1600-0609.1991.tb01539.x

PMID:2044722

Abstract

In contrast to intermediate- and high-grade non-Hodgkin's lymphomas (NHL), patients with follicular lymphomas retain a poor prognosis in the long run. Several reports suggested that they are incurable by conventional chemotherapy. 10 patients with follicular NHL were autografted for consolidation of early remission. One of these patients treated in 1979 received the TACC regimen with unpurged marrow. The other 9 (8 in first, 1 in second remission) treated since July 1987 received the BEAM regimen followed by autologous bone marrow transplantation (ABMT) with marrow purged in vitro by mafosfamide at levels individually adjusted. There were no toxic deaths. 8 patients remain in unmaintained CR 15 to 43 months post-ABMT-2 are beyond 2 years. The patient autografted in 1979 has relapsed 9 yr later. ABMT is feasible with no indue toxicity for consolidation of follicular NHL early in first remission, as an alternative aggressive strategy. Further studies and a longer follow-up will be needed to evaluate its antitumor efficacy.

摘要

与中高级别非霍奇金淋巴瘤（NHL）不同，滤泡性淋巴瘤患者从长远来看预后仍然很差。几份报告表明，传统化疗无法治愈这些患者。10例滤泡性NHL患者接受自体移植以巩固早期缓解。其中1例于1979年接受治疗，采用未净化骨髓的TACC方案。自1987年7月以来治疗的另外9例患者（8例处于首次缓解期，1例处于第二次缓解期）接受了BEAM方案，随后进行自体骨髓移植（ABMT），骨髓在体外经马磷酰胺以个体化调整的水平进行净化。无毒性死亡病例。8例患者在ABMT后15至43个月保持未维持的完全缓解状态，2例超过2年。1979年接受自体移植的患者在9年后复发。ABMT作为一种替代的积极策略，对于巩固首次缓解期早期的滤泡性NHL是可行的，且无过度毒性。需要进一步研究和更长时间的随访来评估其抗肿瘤疗效。