Iqbal Nida, Kumar Lalit, Iqbal Naveed
Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi 110029, India.
Department of Anaesthesia and Intensive Care Unit, Indraprastha Apollo Hospital, New Delhi 110076, India.
ISRN Oncol. 2014 Mar 30;2014:605691. doi: 10.1155/2014/605691. eCollection 2014.
Despite a high clinical success, relapse in Hodgkin lymphoma occurs in 10-30% of cases and 5-10% patients are nonresponsive to initial chemotherapy. The standard management of these patients includes high-dose chemotherapy followed by autologous stem cell transplant. However, 50% of patients ultimately relapse after autotransplant which poses a big challenge. Allogeneic stem cell transplantation offers the only chance of cure in these patients. For patients who are not candidates for allogeneic stem cell transplantation, achieving cure with other possible options is highly unlikely, and thus the treatment plan becomes noncurative. Various novel agents have shown promising results but the duration of response is short lived. A standard approach to deliver the most effective treatment for these patients is still lacking. This review focuses on the treatment options currently available for relapsed and refractory disease after autotransplant.
尽管临床成功率较高,但霍奇金淋巴瘤仍有10%-30%的病例会复发,5%-10%的患者对初始化疗无反应。这些患者的标准治疗包括大剂量化疗,随后进行自体干细胞移植。然而,50%的患者在自体移植后最终仍会复发,这构成了巨大挑战。异基因干细胞移植是这些患者唯一的治愈机会。对于不适合异基因干细胞移植的患者,通过其他可能的选择实现治愈的可能性极小,因此治疗方案无法达到治愈目的。各种新型药物已显示出有前景的结果,但缓解持续时间较短。目前仍缺乏为这些患者提供最有效治疗的标准方法。本综述重点关注自体移植后复发和难治性疾病目前可用的治疗选择。