Jackson G H, Lennard A L, Taylor P R, Carey P, Angus B, Lucraft H, Evans R G, Proctor S J
Department of Haematology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
Br J Cancer. 1994 Sep;70(3):501-5. doi: 10.1038/bjc.1994.335.
We report the safety and efficacy of autologous bone marrow transplantation (ABMT) in 30 patients with high-grade non-Hodgkin's lymphoma (NHL) in first complete remission (CR1) following remission induction chemotherapy. Two patients relapsed prior to ABMT. All patients were conditioned with high-dose melphalan. In Addition, ten received fractionated total body irradiation, one hemi-body irradiation and four high-dose etoposide. Unmanipulated non-cryopreserved autologous marrow was reinfused within 56 h of harvesting. Engraftment occurred in all patients with a median of 11 days of neutropenia (< 0.5 x 10(9) l-1), a median requirement for platelet transfusion of 3 days and packed red cell transfusion of 2 units, with a median hospital stay of 18 days post transplant. There was no procedure-related mortality and only minor morbidity was observed. Two patients relapsed at 1 and 2 months post transplantation, and one patient died of carcinoma of the lung 33 months after transplantation. The remaining 25 patients remain alive, well and in CR1 with a median follow-up of 44 months. The event-free survival at 3 years for all patients considered for ABMT was 83%. We conclude that ABMT for high-grade NHL in CR1 with non-cryopreserved marrow results in rapid haematological recovery without growth factor support. It is safe and is associated with high survival when used as consolidation of CR in high-risk patients.
我们报告了30例首次完全缓解（CR1）的高级别非霍奇金淋巴瘤（NHL）患者接受自体骨髓移植（ABMT）后的安全性和有效性。2例患者在ABMT前复发。所有患者均接受大剂量美法仑预处理。此外，10例接受分次全身照射，1例接受半身照射，4例接受大剂量依托泊苷治疗。未处理的非冷冻保存的自体骨髓在采集后56小时内回输。所有患者均实现造血重建，中性粒细胞减少（<0.5×10⁹/L）的中位时间为11天，血小板输注的中位需求为3天，浓缩红细胞输注2单位，移植后中位住院时间为18天。无手术相关死亡，仅观察到轻微的并发症。2例患者在移植后1个月和2个月复发，1例患者在移植后33个月死于肺癌。其余25例患者存活良好，处于CR1状态，中位随访时间为44个月。所有考虑接受ABMT的患者3年无事件生存率为83%。我们得出结论，对于CR1期的高级别NHL患者，使用非冷冻保存的骨髓进行ABMT可在无生长因子支持的情况下实现快速血液学恢复。当用作高危患者CR的巩固治疗时，它是安全且与高生存率相关的。
