Bureo E, Ortega J J, Muñoz A, Cubells J, Madero L, Verdaguer A, Baro J, Olivé T, Maldonado M S, Pardo N
Hospital Universitario Marques de Valdecilla Servicio de Hematología, Santander, Spain.
Bone Marrow Transplant. 1995 Mar;15(3):353-9.
We report a retrospective analysis on 46 pediatric patients (median age 9 years, range 1-17 years) with non-Hodgkin's lymphoma (NHL), transplanted in six Spanish centers. Fourteen patients underwent allogeneic bone marrow transplantation (BMT) and 32 autologous BMT. Most patients were boys (36 of 46). Twenty one cases were of lymphoblastic lymphoma, 19 Burkitt's lymphoma and six diffuse large cell lymphoma. Maximal Murphy's stage any time before BMT was stage III in 17 cases and stage IV in 29 cases. At BMT, 13 cases were in first CR, 21 in second CR, seven in third CR, four with sensitive active disease and one with refractory disease. All patients transplanted in CRl were considered candidates for BMT because of delayed CR (two cases), failure of the first-line therapy (seven cases) or central nervous system (CNS) or BM infiltration at diagnosis (four cases). Conditioning therapy included TBI in 33 patients and 13 cases were conditioned with chemotherapy alone. Toxic mortality was 13% (three of 14 in the allogeneic BMT group and three of 32 in the autologous group). No toxic deaths were registered in 13 patients undergoing BMT in CR1 (three allogeneic BMT and ten autologous BMT). Twelve patients relapsed 1-7 months after BMT. Overall event-free survival (EFS) was 58% (42-73%; confidence interval (CI) 95%), with a median follow-up of 33 months. EFS was similar for allogeneic BMT and autologous patients. Disease status at BMT was the only predictive factor for EFS (P < 0.01). There were no significant differences between patients in CR1 (82.5%) and CR2 (68%).(ABSTRACT TRUNCATED AT 250 WORDS)
我们报告了一项对46例非霍奇金淋巴瘤（NHL）儿科患者（中位年龄9岁，范围1 - 17岁）的回顾性分析，这些患者在西班牙的六个中心接受了移植。14例患者接受了异基因骨髓移植（BMT），32例接受了自体BMT。大多数患者为男孩（46例中的36例）。21例为淋巴细胞性淋巴瘤，19例为伯基特淋巴瘤，6例为弥漫性大细胞淋巴瘤。BMT前任何时间的最大墨菲分期为Ⅲ期的有17例，Ⅳ期的有29例。在BMT时，13例处于首次完全缓解（CR），21例处于第二次CR，7例处于第三次CR，4例为敏感的活动性疾病，1例为难治性疾病。所有在CR1期接受移植的患者因CR延迟（2例）、一线治疗失败（7例）或诊断时中枢神经系统（CNS）或骨髓浸润（4例）而被视为BMT候选者。预处理方案包括33例患者接受全身照射（TBI），13例仅接受化疗预处理。毒性死亡率为13%（异基因BMT组14例中的3例，自体组32例中的3例）。13例在CR1期接受BMT的患者（3例异基因BMT和10例自体BMT）未记录到毒性死亡。12例患者在BMT后1 - 7个月复发。总体无事件生存率（EFS）为58%（42 - 73%；95%置信区间（CI）），中位随访时间为33个月。异基因BMT和自体患者的EFS相似。BMT时的疾病状态是EFS的唯一预测因素（P < 0.01）。CR1期患者（82.5%）和CR2期患者（68%）之间无显著差异。（摘要截断于250字）
