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[复发性高危恶性淋巴瘤的5年剂量强化及自体骨髓或外周干细胞输注]

[5 years of dosage intensification and autologous bone marrow or peripheral stem cell transfusion in malignant lymphoma with a high risk of recurrence].

作者信息

Jost L M, Pichert G, Reichlin M, Müller E, Jacky E, Honegger H P, Gmür J, Stahel R A

机构信息

Abteilung für Onkologie, Universitätsspital Zürich.

出版信息

Schweiz Med Wochenschr. 1993 May 8;123(18):932-40.

PMID:8098878
Abstract

Clinical results of the treatment of malignant lymphomas with a high risk of relapse by dose intensification and autologous bone marrow transplantation are reported. Since 1988, 68 patients with a median age of 34 years (range 16 to 56 years) received dose intensification, including 25 non-Hodgkin's lymphomas in first remission (12 lymphoblastic or Burkitt's lymphomas and 13 large cell lymphomas with risk factors), 20 aggressive non-Hodgkin's lymphomas in chemosensitive relapse, and 23 Hodgkin's lymphomas in chemosensitive relapse. The calculated 3-year overall survival and relapse-free survival was 72% (CI: 57-82%) and 61% (CI: 47-73%) respectively. Treatment related deaths were seen in 4.4%. The median duration of hospitalization was 30 days (range 19-51 days). The relapse-free 3-year survival for the separate treatment groups was 80% for lymphoblastic and Burkitt's lymphomas in first remission, 77% for large cell lymphomas with clinical risk factors in first remission, 39% for aggressive non-Hodgkin's lymphomas in chemosensitive relapse, and 59% for Hodgkin's lymphomas in chemosensitive relapse. These excellent results were obtained with acceptable toxicity and justify the use of dose intensification for a group of young patients with high risk lymphomas.

摘要

报告了采用剂量强化和自体骨髓移植治疗具有高复发风险恶性淋巴瘤的临床结果。自1988年以来,68例患者(中位年龄34岁,范围16至56岁)接受了剂量强化治疗,其中包括25例首次缓解期的非霍奇金淋巴瘤(12例淋巴母细胞性或伯基特淋巴瘤以及13例具有危险因素的大细胞淋巴瘤)、20例化疗敏感复发的侵袭性非霍奇金淋巴瘤以及23例化疗敏感复发的霍奇金淋巴瘤。计算得出的3年总生存率和无复发生存率分别为72%(置信区间:57 - 82%)和61%(置信区间:47 - 73%)。治疗相关死亡发生率为4.4%。中位住院时间为30天(范围19 - 51天)。各治疗组的3年无复发生存率分别为:首次缓解期的淋巴母细胞性和伯基特淋巴瘤为80%,首次缓解期具有临床危险因素的大细胞淋巴瘤为77%,化疗敏感复发的侵袭性非霍奇金淋巴瘤为39%,化疗敏感复发的霍奇金淋巴瘤为59%。这些优异结果是在可接受的毒性情况下取得的,证明对于一组具有高风险淋巴瘤的年轻患者使用剂量强化治疗是合理的。

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