Seiden M V, Schlossman R, Andersen J, Freeman A, Robertson M, Soiffer R, Freedman A, Mauch P, Ritz J, Nadler L
Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, MA 02115, USA.
Leuk Lymphoma. 1995 Mar;17(1-2):87-93. doi: 10.3109/10428199509051707.
This report describes the clinical characteristics, treatment associated toxicity, and follow-up of fifty-eight patients with plasma cell--dyscrasias treated with high dose chemotherapy and total body irradiation (TBI) at a single institution. Following TBI, 36 patients received anti-B cell monoclonal antibody (MoAb)-treated autologous bone marrow, 21 patients received anti-CD6 cell MoAb-treated allogeneic bone marrow to deplete T cells, and one patient received unpurged bone marrow from a syngeneic donor. Evaluation after high dose chemotherapy and bone marrow transplantation (BMT) demonstrated 26 complete responses (CR), 26 partial responses (PR), 2 non-responders, 1 not yet evaluated, and three toxic deaths. Fourteen of 36 patients who underwent autologous BMT are alive free from progression at 18 (range 5 to 68) months post transplant (post-BMT); of these, 11 remain in continuous complete response at 16 (range 5 to 68) months post-BMT. Seven of 21 patients who underwent allogeneic BMT are alive free from progression at 30 (range 4 to 44) months post-BMT; of these, three patients remain in continuous complete response at 43 (range 33 to 45) months post-BMT. These data suggest that high dose chemotherapy with TBI followed by MoAb purged BM can be performed with acceptable toxicity and high tumor response rates.
本报告描述了在单一机构接受高剂量化疗和全身照射（TBI）治疗的58例浆细胞异常增生患者的临床特征、治疗相关毒性及随访情况。TBI后，36例患者接受了抗B细胞单克隆抗体（MoAb）处理的自体骨髓，21例患者接受了抗CD6细胞MoAb处理的异基因骨髓以清除T细胞，1例患者接受了同基因供体未净化的骨髓。高剂量化疗和骨髓移植（BMT）后的评估显示有26例完全缓解（CR）、26例部分缓解（PR）、2例无反应者、1例尚未评估以及3例因毒性死亡。36例接受自体BMT的患者中有14例在移植后18个月（范围5至68个月）存活且无疾病进展；其中，11例在移植后16个月（范围5至68个月）仍处于持续完全缓解状态。21例接受异基因BMT的患者中有7例在移植后30个月（范围4至44个月）存活且无疾病进展；其中，3例患者在移植后43个月（范围33至45个月）仍处于持续完全缓解状态。这些数据表明，高剂量化疗联合TBI后进行MoAb净化的骨髓移植可以在可接受的毒性和高肿瘤反应率下进行。
