Bosly A, Gisselbrecht C, Coiffier B
Department of Hematology, Catholic University of Louvain, Mont Godinne University Hospital, Yvoir, Belgium.
Nouv Rev Fr Hematol (1978). 1993 Feb;35(1):21-3.
Prognosis of non-Hodgkin's aggressive lymphoma in relapse is very poor. Because of lymphoma high sensitivity to chemotherapy, intensive treatment followed by hematopoietic stem cells transplantation (SCT) could be an appropriate choice. Although randomized studies results are not yet available, evidence of favourable impact of intensive chemotherapy plus SCT was produced by retrospective studies. Our study on relapsing patients after LNH84 regimen showed a longer survival for transplanted patients in comparison with conventional chemotherapy treated patients. In follicular lymphomas after progression, a prolonged event free survival could be achieved at least when an effective marrow purging procedure was obtained. Despite mortality related to complications, allogenic bone marrow transplantation was followed by a low relapse rate suggesting a graft versus lymphoma effect. However, the majority of patients were treated by intensive chemotherapy with autologous stem cells rescue and a great challenge remains to decrease documented high relapse rate.
复发的非霍奇金侵袭性淋巴瘤预后非常差。由于淋巴瘤对化疗高度敏感，强化治疗后进行造血干细胞移植（SCT）可能是一个合适的选择。虽然随机研究结果尚未可得，但回顾性研究提供了强化化疗加SCT产生有利影响的证据。我们对LNH84方案后复发患者的研究表明，与接受传统化疗的患者相比，移植患者的生存期更长。在滤泡性淋巴瘤进展后，至少当获得有效的骨髓净化程序时，可以实现延长的无事件生存期。尽管存在与并发症相关的死亡率，但异基因骨髓移植后的复发率较低，提示移植物抗淋巴瘤效应。然而，大多数患者接受了强化化疗并进行自体干细胞救援，降低已记录的高复发率仍然是一个巨大的挑战。
