Mendoza E, Territo M, Schiller G, Lill M, Kunkel L, Wolin M
Department of Medicine, UCLA School of Medicine 90024, USA.
Bone Marrow Transplant. 1995 Feb;15(2):299-303.
We studied 23 consecutive patients, median age 34 years, with relapsed or resistant aggressive lymphoma who underwent allogeneic BMT at the UCLA Medical Center Bone Marrow Transplantation Unit from 1 November 1984 to 30 March 1993. All patients were < 50 years of age and had sibling donors who were matched at the HLA-A, B and DR loci. Nine patients had Hodgkin's disease (HD) and 14 had non-Hodgkin's lymphoma (NHL); three of these had low grade histology and 11 had intermediate or high grade lymphoma histology. After a median follow-up of 34 months, eight patients are alive, seven without recurrent lymphoma. Five patients had early deaths. The disease-free survival for the entire group is 26% with an overall survival of 29%. There was no difference in survival rate on the basis of disease or histology. Comparing preparative regimens containing TBI to those without there was no difference in survival rate (P = 0.35). Neither age nor sex was a significant determinant of outcome (P = 0.63 and 0.36, respectively). Disease status at the time of transplantation proved to be the important determinant of outcome. Patients transplanted with chemotherapy sensitive disease (n = 9), defined as a partial or complete response to salvage chemotherapy, had a survival rate of 42%, which was significantly better than those who had refractory disease at transplantation (n = 14), who had a survival rate of 21% (P = 0.006). However, this small, but significant fraction of patients with refractory disease was curable. Thus, our data demonstrate that allogeneic bone marrow transplantation is an effective means of treatment for relapsed or aggressive Hodgkin's and non-Hodgkin's lymphoma.
我们研究了1984年11月1日至1993年3月30日在加州大学洛杉矶分校医学中心骨髓移植科接受异基因骨髓移植的23例连续患者，这些患者均为复发或难治性侵袭性淋巴瘤，中位年龄34岁。所有患者年龄均小于50岁，且有在HLA - A、B和DR位点相匹配的同胞供者。9例患者患有霍奇金病（HD），14例患有非霍奇金淋巴瘤（NHL）；其中3例为低级别组织学类型，11例为中级或高级别淋巴瘤组织学类型。中位随访34个月后，8例患者存活，7例无淋巴瘤复发。5例患者早期死亡。整个组的无病生存率为26%，总生存率为29%。基于疾病类型或组织学类型的生存率无差异。含全身照射（TBI）的预处理方案与不含TBI的方案相比，生存率无差异（P = 0.35）。年龄和性别均不是预后的显著决定因素（P分别为0.63和0.36）。移植时的疾病状态被证明是预后的重要决定因素。接受化疗敏感疾病移植的患者（n = 9），即对挽救性化疗有部分或完全反应者，生存率为42%，显著高于移植时患有难治性疾病的患者（n = 14），后者生存率为21%（P = 0.006）。然而，这一小部分但显著比例的难治性疾病患者是可治愈的。因此，我们的数据表明异基因骨髓移植是复发或侵袭性霍奇金淋巴瘤和非霍奇金淋巴瘤的一种有效治疗手段。
