Fridrik M A
I. Medizinischen Abteilung, Allgemeinen Krankenhauses Linz.
Acta Med Austriaca. 1993;20(3):70-7.
High malignant non-Hodgkin's lymphomas are rare diseases, with a rising incidence. A qualified histological classification and a thorough staging are the most important points in the further management. The treatment is primarily chemotherapeutic; radiation is only used in selected situations. The success of the very first therapy is most important for the outcome. To date no one of the modern intensive treatment regimens could show an advantage over conventional CHOP. For treatment failures autologous or allogenic bone-marrow-transplantation is the best option. Whether bone-marrow-transplantation in first remission can improve the treatment results waits to be answered. HIV-associated lymphomas are an increasing problem. For selected patients intensive chemotherapy with growth factors seems to improve the results. Conflicting are the therapy data in elderly patients. Most centers accept a higher lymphoma mortality with reduced doses. With special designed treatment regimens it is probably possible to come to an acceptable outcome even in elderly patients.
高度恶性非霍奇金淋巴瘤是罕见疾病，发病率呈上升趋势。合格的组织学分类和全面的分期是后续治疗中最重要的要点。治疗主要采用化疗；放疗仅在特定情况下使用。首次治疗的成功对治疗结果最为重要。迄今为止，没有一种现代强化治疗方案能显示出优于传统CHOP方案的优势。对于治疗失败的患者，自体或异体骨髓移植是最佳选择。首次缓解期进行骨髓移植是否能改善治疗效果尚待解答。与HIV相关的淋巴瘤问题日益突出。对于部分患者，使用生长因子的强化化疗似乎能改善治疗结果。老年患者的治疗数据存在矛盾。大多数中心接受降低剂量时较高的淋巴瘤死亡率。通过特殊设计的治疗方案，即使是老年患者也可能获得可接受的治疗结果。
