Rossi A, Cortelazzo S, Bellavita P, Viero P, Bassan R, Comotti B, Marchioli R, Marfisi R M, Rambaldi A, Barbui T
Division of Haematology, Ospedali Riuniti di Bergamo, Italy.
Br J Haematol. 1997 Mar;96(3):620-6. doi: 10.1046/j.1365-2141.1997.d01-2060.x.
We report on long-term haematological recovery and clinical outcome after high-dose chemotherapy supported by circulating progenitor cells (CPC) transplantation in non-Hodgkin's lymphoma (NHL) patients, and analyse the role of variables which might influence engraftment. 63 consecutive NHL patients were enrolled in this study. Two groups of patients were considered for analysis: the first 34 patients had untreated diffuse large cell lymphoma with unfavourable prognostic factors. A second group of 29 patients underwent transplantation for resistant or relapsing NHL with low, intermediate and high grade histology. All patients received the BEAM conditioning regimen. As already reported in many studies, all patients showed a rapid haematological reconstitution. 43 patients (68%) achieved long-term complete trilineage engraftment within a median of 107 d from CPC transplantation. The neutrophil count was the first parameter reaching complete normalization, and haemoglobin was the last. Failure to meet the trilineage levels was due to lack of platelet recovery and was more frequent in patients transplanted in the setting of salvage protocols. By Kaplan-Meier analysis, the probability of a full reconstitution was 80% in patients to whom transplant was offered as part of a front-line therapy and 50% when transplant was given in the salvage programmes. Multivariate analysis showed that sustained long-term haematological reconstitution was significantly related to younger age, the time taken to achieve short-term reconstitution, and bone marrow involvement.
我们报告了非霍奇金淋巴瘤（NHL）患者在循环祖细胞（CPC）移植支持下进行大剂量化疗后的长期血液学恢复情况和临床结局，并分析了可能影响植入的变量的作用。本研究纳入了63例连续的NHL患者。分析时考虑了两组患者：前34例患者患有未经治疗的弥漫性大细胞淋巴瘤，具有不良预后因素。第二组29例患者因低、中、高分级组织学的耐药或复发NHL接受移植。所有患者均接受BEAM预处理方案。正如许多研究中已经报道的那样，所有患者均表现出快速的血液学重建。43例患者（68%）在CPC移植后的中位107天内实现了长期完全三系植入。中性粒细胞计数是第一个达到完全正常化的参数，血红蛋白是最后一个。未能达到三系水平是由于血小板恢复不良，在挽救方案背景下移植的患者中更常见。通过Kaplan-Meier分析，作为一线治疗一部分接受移植的患者完全重建的概率为80%，而在挽救方案中接受移植的患者为50%。多变量分析表明，持续的长期血液学重建与年龄较小、实现短期重建所需的时间以及骨髓受累显著相关。
