Zahid Umar, Akbar Faisal, Amaraneni Akshay, Husnain Muhammad, Chan Onyee, Riaz Irbaz Bin, McBride Ali, Iftikhar Ahmad, Anwer Faiz
Department of Medicine, University of Arizona, Tucson, AZ, USA.
College of Public Health, University of Arizona, Tucson, AZ, USA.
Curr Hematol Malig Rep. 2017 Jun;12(3):217-226. doi: 10.1007/s11899-017-0382-1.
Chemotherapy remains the first-line therapy for aggressive lymphomas. However, 20-30% of patients with non-Hodgkin lymphoma (NHL) and 15% with Hodgkin lymphoma (HL) recur after initial therapy. We want to explore the role of high-dose chemotherapy (HDT) and autologous stem cell transplant (ASCT) for these patients.
There is some utility of upfront consolidation for-high risk/high-grade B-cell lymphoma, mantle cell lymphoma, and T-cell lymphoma, but there is no role of similar intervention for HL. New conditioning regimens are being investigated which have demonstrated an improved safety profile without compromising the myeloablative efficiency for relapsed or refractory HL. Salvage chemotherapy followed by HDT and rescue autologous stem cell transplant remains the standard of care for relapsed/refractory lymphoma. The role of novel agents to improve disease-related parameters remains to be elucidated in frontline induction, disease salvage, and high-dose consolidation or in the maintenance setting.
化疗仍然是侵袭性淋巴瘤的一线治疗方法。然而，20%-30%的非霍奇金淋巴瘤（NHL）患者和15%的霍奇金淋巴瘤（HL）患者在初始治疗后会复发。我们想要探讨大剂量化疗（HDT）和自体干细胞移植（ASCT）在这些患者中的作用。
对于高危/高级别B细胞淋巴瘤、套细胞淋巴瘤和T细胞淋巴瘤，前期巩固治疗有一定作用，但对HL没有类似干预作用。正在研究新的预处理方案，这些方案已证明在不影响复发或难治性HL的清髓效率的情况下安全性有所改善。挽救性化疗后进行HDT和救援自体干细胞移植仍然是复发/难治性淋巴瘤的标准治疗方法。新型药物在一线诱导、疾病挽救、大剂量巩固或维持治疗中改善疾病相关参数的作用仍有待阐明。
