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接受自体骨髓移植治疗非霍奇金淋巴瘤患者的预后因素。西班牙协作组GEL/TAMO的104例患者报告

Prognostic factors in patients who received autologous bone marrow transplantation for non-Hodgkin's lymphoma. Report of 104 patients from the Spanish Cooperative Group GEL/TAMO.

作者信息

Conde E, Sierra J, Iriondo A, Domingo A, García Laraña J, Marín J, Caballero D, Martínez F, León A, García-Conde J

机构信息

Servicio de Hematologia, Hospital Universitario Marques de Valdecilla, Universidad de Cantabria, Santander, Spain.

出版信息

Bone Marrow Transplant. 1994 Aug;14(2):279-86.

PMID:7994243
Abstract

One hundred and four patients with low grade (9 patients), intermediate grade (31 patients) and high grade (64 patients) non-Hodgkin's lymphoma received an autologous bone marrow transplantation (BMT). Disease status at transplant was first complete remission (CR) in 46 patients, second CR in 14 patients, third CR in 7 patients, chemosensitive disease in 16 patients and chemoresistant disease in 21 patients. Estimated 5 year disease-free survival (DFS) for all 104 patients was 49% (95% confidence interval (CI), 36-63%) with a median follow-up of 24 months. Five year relapse rate for 80 evaluable patients was 26% (95% CI, 14-44%). The 8 year DFS and relapse for the 46 patients transplanted in first CR were 75% (95% CI, 63-82%) and 15% (95% CI, 7-33%), respectively, with a median follow-up of 27 months (range 13-104 months) and a median time to relapse of 5 months (range 4-20 months). In the univariate analysis, variables correlated with DFS were performance status at autologous BMT, disease status at autologous BMT, LDH level at autologous BMT, failure to achieve CR at diagnosis, front-line chemotherapy (1 vs 2 or more regimens) and Working Formulation. Variables correlated with relapse were disease status at autologous BMT, preparative regimen and Coiffer's index at diagnosis. Multivariate analysis showed that performance status was the only independent predictor of DFS and that disease status at autologous BMT was the best relapse predicting variable. In patients transplanted in first CR, the variables correlated with DFS were stage at diagnosis and performance status at autologous BMT.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

104例低级别(9例)、中级别(31例)和高级别(64例)非霍奇金淋巴瘤患者接受了自体骨髓移植(BMT)。移植时的疾病状态为首次完全缓解(CR)46例、第二次CR 14例、第三次CR 7例、化疗敏感疾病16例和化疗耐药疾病21例。104例患者的估计5年无病生存率(DFS)为49%(95%置信区间(CI),36 - 63%),中位随访时间为24个月。80例可评估患者的5年复发率为26%(95% CI,14 - 44%)。46例首次CR时接受移植患者的8年DFS和复发率分别为75%(95% CI,63 - 82%)和15%(95% CI,7 - 33%),中位随访时间为27个月(范围13 - 104个月),中位复发时间为5个月(范围4 - 20个月)。单因素分析中,与DFS相关的变量有自体BMT时的体能状态、自体BMT时的疾病状态、自体BMT时的乳酸脱氢酶水平、诊断时未达到CR、一线化疗(1种方案与2种或更多方案)以及工作分类法。与复发相关的变量有自体BMT时的疾病状态、预处理方案和诊断时的Coiffer指数。多因素分析显示体能状态是DFS的唯一独立预测因素,而自体BMT时的疾病状态是最佳的复发预测变量。在首次CR时接受移植的患者中,与DFS相关的变量有诊断时的分期和自体BMT时的体能状态。(摘要截选至250词)

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