Cucuianu A, D'Hondt L, Collignon J, Verhulst D, Deprijck B, Chatelain C, Doyen C, Bosly A
Oncologic Institute-Cluj, Department of Malignant Hemopaties, Cluj-Napoca, Romania.
Rom J Intern Med. 1995 Jul-Dec;33(3-4):211-25.
The present paper is an attempt to assess the efficiency of high-dose cytotoxic therapy followed by autologous bone marrow or peripheral progenitor cell rescue with hematopoietic growth factor support given in a group of 27 patients (16 men, 11 women) at the Department of Hematology of the Mont Godinne University Clinics, mainly in the same interval 1990-1994. The reasons for introducing such a therapy in these patients (6 with Hodgkin's disease, 14 with intermediate or high grade, aggressive non Hodgkin lymphomas and 7 with low grade follicular non Hodgkin lymphomas) were relapse of disease after conventional therapy (11 cases), resistance to initial therapy (5 patients) or because of histologically proven transformation to a more aggressive form (one case); in 10 patients with extended, poor prognosis forms, the procedure was used as part of the first line therapy. The conditioning high dose chemotherapy was given according to various regimens, most of them containing Cyclophosphamide, BCNU and Etoposide, with or without total body irradiation. In 14 patients, bone marrow (BM) graft was used, while peripheral blood progenitor cells (PBPC) were infused in the remaining 13 patients. The number of infused granulocyte-macrophage colony forming units (CFU-GM) ranged between 7,650 and 3,900,000/kg, with a mean value of 461,000/kg. The median time intervals required to reach an absolute neutrophil count > 500/microliter, a platelet count > 50,000/microliter and a hematocrit > 30% were 13 days, 20 days and 23 days respectively. Growth factors (GM-CSF and G-CSF) and PBPC use shortened the time for neutrophil recovery as well as neutropenia-related complications. No procedure-related death was observed and complete remission was achieved in 22 cases (81.4%); after a mean follow-up of 32.6 months, 14 patients (55.5%) are alive and free of disease, while in 7 patients (31% of the complete responders) relapse occurred at an average time interval of 8.2 months since the procedure.
本文旨在评估高剂量细胞毒性疗法的疗效，该疗法随后采用自体骨髓或外周祖细胞救援，并辅以造血生长因子支持，研究对象为蒙戈丁讷大学诊所血液科的27名患者（16名男性，11名女性），主要集中在1990年至1994年的同一时间段。在这些患者中（6例霍奇金淋巴瘤、14例中高级别侵袭性非霍奇金淋巴瘤和7例低级别滤泡性非霍奇金淋巴瘤）采用这种疗法的原因包括传统治疗后疾病复发（11例）、对初始治疗耐药（5例患者）或组织学证实已转化为更具侵袭性的形式（1例）；在10例预后较差的广泛性疾病患者中，该程序被用作一线治疗的一部分。预处理高剂量化疗根据不同方案进行，其中大多数方案包含环磷酰胺、卡莫司汀和依托泊苷，有或没有全身照射。14例患者使用了骨髓（BM）移植，其余13例患者输注了外周血祖细胞（PBPC）。输注的粒细胞-巨噬细胞集落形成单位（CFU-GM）数量在7,650至3,900,000/kg之间，平均值为461,000/kg。达到绝对中性粒细胞计数>500/微升、血小板计数>50,000/微升和血细胞比容>30%所需的中位时间间隔分别为13天、20天和23天。生长因子（GM-CSF和G-CSF）以及PBPC的使用缩短了中性粒细胞恢复时间以及与中性粒细胞减少相关的并发症。未观察到与治疗相关的死亡，22例患者（81.4%）实现了完全缓解；平均随访32.6个月后，14例患者（55.5%）存活且无疾病，而7例患者（占完全缓解者的31%）在治疗后平均8.2个月的时间间隔复发。
