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大剂量疗法及自体骨髓移植用于成人高级别非霍奇金淋巴瘤患者首次完全缓解期:欧洲骨髓移植组淋巴瘤工作组的经验

High-dose therapy and autologous bone marrow transplantation in first complete remission for adult patients with high-grade non-Hodgkin's lymphoma: the EBMT experience. Lymphoma Working Party of the European Group for Bone Marrow Transplantation.

作者信息

Sweetenham J W, Proctor S J, Blaise D, De Laurenzi A, Pearce R, Taghipour G, Goldstone A H, Laurenzi A [corrected to De Laurenzi A ]

机构信息

CRC Wessex Medical Oncology Unit, University of Southampton, Southampton General Hospital, UK.

出版信息

Ann Oncol. 1994;5 Suppl 2:155-9. doi: 10.1093/annonc/5.suppl_2.s155.

Abstract

One hundred and eighteen patients presenting with high-grade non-Hodgkin's lymphoma, undergoing autologous bone marrow transplantation (ABMT) in first complete remission (CR), have been reported to the European Group for Bone Marrow Transplantation (EBMT). Of these, 102 were eligible for inclusion in this study following review of registration forms. Patients with lymphoblastic lymphoma were excluded. Remission induction and high-dose regimens varied between contributing centres. A maintained CR was observed in 90% of patients. Early relapse was observed in 6%, and 4% suffered toxic deaths. With a median follow-up of 45 months (3-112 months), the 5-year actuarial overall and progression-free survivals are both 70%. Nineteen (18%) patients relapsed at a median of 3.5 months (0.25-52 months) after ABMT, only 1 achieving a further durable CR. The only factor with prognostic significance was histological subtype, with diffuse small noncleaved-cell lymphoma having a significantly worse outcome. High-dose therapy and ABMT has produced effective consolidation of first remission in this group of patients, even in those with poor prognostic features at presentation.

摘要

欧洲骨髓移植组(EBMT)报告了118例患有高度非霍奇金淋巴瘤且在首次完全缓解(CR)时接受自体骨髓移植(ABMT)的患者。其中,在审查登记表后,有102例符合纳入本研究的条件。淋巴细胞性淋巴瘤患者被排除在外。各参与中心的缓解诱导和高剂量方案各不相同。90%的患者维持了CR。6%的患者出现早期复发,4%的患者死于毒性反应。中位随访时间为45个月(3 - 112个月),5年精算总生存率和无进展生存率均为70%。19例(18%)患者在ABMT后中位3.5个月(0.25 - 52个月)复发,只有1例再次获得持久CR。唯一具有预后意义的因素是组织学亚型,弥漫性小无裂细胞淋巴瘤的预后明显更差。高剂量治疗和ABMT在这组患者中有效巩固了首次缓解,即使是那些初诊时具有不良预后特征的患者。

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