自体干细胞移植在弥漫性大B细胞淋巴瘤治疗中的作用。
The role of autologous stem cell transplantation in the treatment of diffuse large B-cell lymphoma.
作者信息
Gunnellini Marco, Emili Rita, Coaccioli Stefano, Liberati Anna Marina
机构信息
Department of Transplant Oncohematology, Perugia University, S. Maria, Terni, Italy.
出版信息
Adv Hematol. 2012;2012:195484. doi: 10.1155/2012/195484. Epub 2012 Jan 18.
Abstract
Diffuse large B-cell non-Hodgkin's lymphoma (DLBCL) accounting for approximately 30% of new lymphoma diagnoses in adult patients. Complete remissions (CRs) can be achieved in 45% to 55% of patients and cure in approximately 30-35% with anthracycline-containing combination chemotherapy. The ageadjusted IPI (aaIPI) has been widely employed, particularly to "tailor" more intensive therapy such as high-dose therapy (HDT) with autologous hemopoietic stem cell rescue (ASCT). IPI, however, has failed to reliably predict response to specific therapies. A subgroup of young patients with poor prognosis exists. To clarify the role of HDT/ASCT combined with rituximab in the front line therapy a longer follow-up and randomized studies are needed. The benefit of HDT/ASCT for refractory or relapsed DLBCL is restricted to patients with immunochemosensitive disease. Currently, clinical and biological research is focused to improve the curability of this setting of patients, mainly young.
摘要
弥漫性大B细胞非霍奇金淋巴瘤（DLBCL）约占成年患者新诊断淋巴瘤的30%。采用含蒽环类药物的联合化疗，45%至55%的患者可实现完全缓解（CR），约30%至35%的患者可治愈。年龄校正国际预后指数（aaIPI）已被广泛应用，特别是用于“定制”更强化的治疗，如采用自体造血干细胞救援（ASCT）的高剂量治疗（HDT）。然而，IPI未能可靠地预测对特定治疗的反应。存在一个预后不良的年轻患者亚组。为了阐明HDT/ASCT联合利妥昔单抗在一线治疗中的作用，需要更长时间的随访和随机研究。HDT/ASCT对难治性或复发性DLBCL的益处仅限于免疫化疗敏感的患者。目前，临床和生物学研究主要集中在提高这类患者（主要是年轻患者）的治愈率上。
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