Gaspard M H, Maraninchi D, Stoppa A M, Gastaut J A, Michel G, Tubiana N, Blaise D, Novakovitch G, Rossi J F, Weiller P J
Marrow Transplant Unit, Inserm U119-Institut Paoli-Calmettes, Marseille, France.
Cancer Chemother Pharmacol. 1988;22(3):256-62. doi: 10.1007/BF00273421.
Twenty-six patients (median age 33 years) with poor-risk malignancies were treated with high-dose combination chemotherapy associating BCNU-etoposide-cytosine arabinoside and melphalan (BEAM) followed by autologous bone marrow transplantation (ABMT). Twenty-one patients had malignant lymphomas, three, acute lymphoblastic leukemia (ALL), and two, malignant thymomas. Eleven patients (group 1) were not in complete remission (CR) at the time of BEAM, and fifteen patients (group 2) were in CR. Hematological recovery occurred in all patients. The duration of aplasia and the non-hematological toxicities were similar in both groups. Ten of the eleven patients (group 1) evaluable for response achieved CR and one achieved partial remission (PR). Five patients relapsed, and five are in continuous CR with a short follow-up (median 8 months). Among the fifteen patients in CR at the time of BEAM (group 2), four patients relapsed and ten patients are in unmaintained continuous CR with a median follow-up of 15 months (one patient died in CR). The disease-free survival is 53%, with 29% for patients receiving BEAM while in relapse (group 1) and 65% for patients receiving BEAM while in CR (group 2). These data indicate that BEAM followed by ABMT can produce a high antitumor response with an acceptable toxicity in patients with poor-risk malignancies.
26例（中位年龄33岁）预后不良的恶性肿瘤患者接受了大剂量联合化疗，化疗方案为卡莫司汀-依托泊苷-阿糖胞苷联合美法仑（BEAM），随后进行自体骨髓移植（ABMT）。21例患者患有恶性淋巴瘤，3例患有急性淋巴细胞白血病（ALL），2例患有恶性胸腺瘤。11例患者（第1组）在接受BEAM化疗时未达到完全缓解（CR），15例患者（第2组）达到CR。所有患者均实现血液学恢复。两组的无细胞期持续时间和非血液学毒性相似。第1组中可评估缓解情况的11例患者中有10例达到CR，1例达到部分缓解（PR）。5例患者复发，5例处于持续CR状态，随访时间较短（中位8个月）。在接受BEAM化疗时达到CR的15例患者（第2组）中，4例患者复发，10例患者处于未维持的持续CR状态，中位随访时间为15个月（1例患者在CR状态下死亡）。无病生存率为53%，接受BEAM化疗时处于复发状态的患者（第1组）为29%，接受BEAM化疗时处于CR状态的患者（第2组）为65%。这些数据表明，BEAM化疗后进行ABMT可在预后不良的恶性肿瘤患者中产生高抗肿瘤反应，且毒性可接受。
