Philip T, Dumont J, Teillet F, Maraninchi D, Gorin N C, Kuentz M, Harousseau J L, Marty M, Pinkerton R, Herve P
Br J Cancer. 1986 Jun;53(6):737-42. doi: 10.1038/bjc.1986.127.
Seventeen patients with Hodgkin's disease (HD) were treated with high-dose chemotherapy followed by autologous bone marrow transplantation (ABMT). Eleven patients were resistant to initial therapy. Three patients had relapsed and were still responders to second or third line therapy. Three patients had relapsed but were progressing under second or third line therapy. Pre-ABMT chemotherapy included high dose cyclophosphamide in all patients (50 mg Kg-1 day-1 bolus for 4 days), most often associated with BCNU or CCNU, aracytine and 6 thioguanine. Four patients received additional TBI (10 Gy). In 9 patients complete remission (CR) was achieved, 4 failed to respond and 4 cases were not evaluable due to early death. Among CR patients, 2 died from late toxicity, 4 relapsed between the 2nd and 5th months, but 3 patients remain in CR, off therapy at 25+, 43+, and 66+ months, including 1/11 initially resistant and 2/6 who had relapsed. There were 9 treatment related deaths: 6 due to infection, 1 cardiac failure and 2 multiorgan failure. The high complete response rate in these heavily pretreated patients suggests that there may be an indication for high dose therapy earlier in resistant HD. Moreover under such conditions, treatment related morbidity would be expected to be lower.
17例霍奇金病（HD）患者接受了大剂量化疗，随后进行自体骨髓移植（ABMT）。11例患者对初始治疗耐药。3例患者复发，但对二线或三线治疗仍有反应。3例患者复发，但在二线或三线治疗过程中病情进展。ABMT前的化疗方案为所有患者均接受大剂量环磷酰胺（50mg·kg-1·d-1，静脉推注4天），多数联合卡氮芥或环己亚硝脲、阿糖胞苷和6-硫鸟嘌呤。4例患者还接受了全身照射（10Gy）。9例患者达到完全缓解（CR），4例无反应，4例因早期死亡无法评估。在CR患者中，2例死于晚期毒性反应，4例在第2至5个月复发，但3例患者仍处于CR状态，分别在25+、43+和66+个月时停止治疗，其中包括1例最初耐药患者和2例复发患者中的2例。有9例与治疗相关的死亡：6例死于感染，1例死于心力衰竭，2例死于多器官功能衰竭。这些经过大量预处理患者的高完全缓解率表明，对于耐药HD患者，早期进行大剂量治疗可能有指征。此外，在这种情况下，预计治疗相关的发病率会更低。
