Wu G Q
Department of Medical Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing.
Zhonghua Zhong Liu Za Zhi. 1993 Jan;15(1):47-51.
Four patients with advanced adult high-grade malignant T-cell non-Hodgkin's lymphoma (NHL) were treated with high dose chemoradiotherapy and ABMT as a first line therapy. Case 1 was of stage IIIb; case 2, 3 and 4 were of stage IV. Bone marrow was involved (19% blast cells) in case 2, and nervous system was involved in case 4. All of them were given at first an inductive chemotherapy with 3-4 courses of BACOP regimen before ABMT. 40-50 days later, Vp-16, CTX and TBI were given as a conditioning regimen (case 1: TLI). Case 1 and 2 only reached partial remission after inductive treatment (case 2: relapse at primary sites one month after inductive therapy, but complete remission (CR) of bone marrow). All of the four patients reached CR after ABMT. Case 2 had systemic relapse (bone marrow blast cells: 8%) at 110 days after CR and died from relapse 210 days after ABMT. So far, case 1, 3 and 4 have survived free of disease for 24, 19 and 9 months, respectively. There was no fatal marrow transplant regimen-related toxicity during inductive and ABMT treatment. The results of this pilot study suggest that treatment of high-grade malignant NHL may be improved by combined use of high dose chemoradiotherapy and ABMT, and the toxicities can be tolerated.
4例晚期成人高级别恶性T细胞非霍奇金淋巴瘤（NHL）患者接受了大剂量放化疗及自体骨髓移植（ABMT）作为一线治疗。病例1为Ⅲb期；病例2、3和4为Ⅳ期。病例2骨髓受累（原始细胞19%），病例4神经系统受累。所有患者在ABMT前首先接受3 - 4个疗程的BACOP方案诱导化疗。40 - 50天后，给予Vp - 16、环磷酰胺（CTX）和全身照射（TBI）作为预处理方案（病例1：全身淋巴结照射）。病例1和2诱导治疗后仅达到部分缓解（病例2：诱导治疗1个月后原发部位复发，但骨髓完全缓解）。4例患者ABMT后均达到完全缓解。病例2在完全缓解后110天出现全身复发（骨髓原始细胞：8%），并在ABMT后210天死于复发。目前，病例1、3和4分别无病生存24、19和9个月。诱导治疗及ABMT期间未出现与骨髓移植方案相关的致命毒性反应。这项初步研究结果提示，联合应用大剂量放化疗及ABMT可能改善高级别恶性NHL的治疗效果，且毒性反应可耐受。
