Appelbaum F R, Sullivan K M, Buckner C D, Clift R A, Deeg H J, Fefer A, Hill R, Mortimer J, Neiman P E, Sanders J E
J Clin Oncol. 1987 Sep;5(9):1340-7. doi: 10.1200/JCO.1987.5.9.1340.
Between July 1970 and January 1985, 100 patients with malignant lymphoma were treated with high-dose chemoradiotherapy and bone marrow transplantation. Twenty-eight of the 100 are alive and the actuarial probability of disease-free survival 5 years from transplantation is 22%. The most common reason for treatment failure was disease recurrence, with an actuarial probability of 60%. A proportional hazards regression analysis showed that the likelihood of disease-free survival was less in those patients transplanted in resistant relapse and in those previously treated with chest radiotherapy. Neither disease histology (Hodgkin's disease, high-grade lymphoma or intermediate-grade lymphoma), nor source of marrow (syngeneic, allogeneic, or autologous) significantly influenced either disease-free survival or probability of relapse. The use of high-dose chemoradiotherapy and marrow transplantation appears to offer a better chance for long-term survival than any other form of therapy for young patients with disseminated malignant lymphoma whose disease has progressed after initial combination chemotherapy. The best results with marrow transplantation were obtained in patients transplanted in early relapse or second remission who had not received prior chest radiotherapy.
1970年7月至1985年1月期间，100例恶性淋巴瘤患者接受了大剂量放化疗及骨髓移植治疗。100例患者中有28例存活，移植后5年无病生存的精算概率为22%。治疗失败的最常见原因是疾病复发，精算概率为60%。比例风险回归分析显示，在耐药复发时接受移植的患者以及先前接受过胸部放疗的患者中，无病生存的可能性较小。疾病组织学类型（霍奇金病、高级别淋巴瘤或中级别淋巴瘤）以及骨髓来源（同基因、异基因或自体）均未对无病生存或复发概率产生显著影响。对于初治联合化疗后疾病进展的播散性恶性淋巴瘤年轻患者，大剂量放化疗及骨髓移植似乎比其他任何治疗方式都更能提供长期生存的机会。骨髓移植的最佳效果出现在早期复发或第二次缓解时接受移植且未接受过先前胸部放疗的患者中。
