Bigler R D, Crilley P, Micaily B, Brady L W, Topolsky D, Bulova S, Vonderheid E C, Brodsky I
Department of Neoplastic Diseases, Hahnemann University, Philadelphia, PA 19102.
Bone Marrow Transplant. 1991 Feb;7(2):133-7.
Patients with advanced stage cutaneous T cell lymphoma (CTCL) have a median survival of 2-5 years with no currently available curative therapy. This limited pilot study was performed to determine if CTCL patients could undergo autologous bone marrow transplantation (ABMT) as a curative treatment without developing life-threatening infections. Since selection of a chemotherapeutic regimen is essentially empirical at this time, several drug combinations were screened. Total skin electron beam radiotherapy was used prior to transplantation to control the skin disease of four patients. Six patients have been transplanted and all have engrafted normally. Infections that developed after transplantation responded to conventional therapy and were typical of those observed in other patients undergoing ABMT. Five of the six patients had a complete clinical response to ABMT but three of these responses lasted less than 100 days. Two recent patients who were treated with carmustine, etoposide, and cisplatin are alive more than 1 year after transplantation without evidence of active disease. Thus, although this study does not prove the efficacy of ABMT, it does demonstrate that patients with CTCL can undergo ABMT without developing life-threatening infections and that carmustine-etoposide-cisplatin plus ABMT should be evaluated in subsequent studies to treat patients with poor prognosis CTCL.
晚期皮肤T细胞淋巴瘤（CTCL）患者的中位生存期为2至5年，目前尚无治愈性疗法。进行这项有限的试点研究是为了确定CTCL患者能否接受自体骨髓移植（ABMT）作为一种治愈性治疗而不发生危及生命的感染。由于目前化疗方案的选择基本上是经验性的，因此对几种药物组合进行了筛选。在移植前使用全身皮肤电子束放疗来控制4例患者的皮肤疾病。6例患者已接受移植，均正常植入。移植后发生的感染对传统治疗有反应，是接受ABMT的其他患者中常见的感染类型。6例患者中有5例对ABMT有完全的临床反应，但其中3例反应持续时间不到100天。最近接受卡莫司汀、依托泊苷和顺铂治疗的2例患者在移植后存活超过1年，无疾病活动迹象。因此，虽然这项研究没有证明ABMT的疗效，但它确实表明CTCL患者可以接受ABMT而不发生危及生命的感染，并且卡莫司汀-依托泊苷-顺铂联合ABMT应在后续研究中进行评估，以治疗预后不良的CTCL患者。
