Zulian G B, Selby P, Milan S, Nandi A, Gore M, Forgeson G, Perren T J, McElwain T J
Section of Medicine, Royal Marsden Hospital, Sutton, Surrey, UK.
Br J Cancer. 1989 Apr;59(4):631-5. doi: 10.1038/bjc.1989.128.
Thirty-eight patients with previously treated Hodgkin's disease were given high dose combination chemotherapy using melphalan and BCNU and autologous bone marrow transplantation. In 25 patients etoposide was added in conventional dosage. During the course of the study the dose of melphalan was increased from 80 to 140 mg m-2 and the dose of BCNU from 300 to 600 mg m-2. The response rate was 76% with 53% complete remission. Forty-five per cent of the patients are free of disease at 4-20 months follow-up. There were eight (26%) treatment-related deaths due to lung damage (seven cases) and irreversible cardiac failure (one case). Fatal lung damage occurred only in patients receiving 600 mg m-2 of BCNU with high dose melphalan. The dose of BCNU given with high dose melphalan should not exceed 500 mg m-2. This treatment is effective against relapsed Hodgkin's disease but must be used cautiously. The best time for its use remains to be determined.
38例曾接受过治疗的霍奇金病患者接受了使用美法仑和卡氮芥的大剂量联合化疗及自体骨髓移植。25例患者加用了常规剂量的依托泊苷。在研究过程中，美法仑的剂量从80mg/m²增加到140mg/m²，卡氮芥的剂量从300mg/m²增加到600mg/m²。缓解率为76%，完全缓解率为53%。45%的患者在4至20个月的随访中无疾病。有8例（26%）与治疗相关的死亡，原因是肺损伤（7例）和不可逆的心力衰竭（1例）。致命的肺损伤仅发生在接受600mg/m²卡氮芥和大剂量美法仑的患者中。与大剂量美法仑联合使用时，卡氮芥的剂量不应超过500mg/m²。这种治疗对复发性霍奇金病有效，但必须谨慎使用。其最佳使用时间仍有待确定。
