Salzman D E, Briggs A D, Vaughan W P
University of Alabama at Birmingham, Alabama 35294-0006, USA.
Am J Med Sci. 1997 Apr;313(4):228-35. doi: 10.1097/00000441-199704000-00006.
High dose chemotherapy and stem-cell rescue (bone marrow transplantation) is used increasingly in the treatment of malignant disorder. Numerous trials have demonstrated the effectiveness of bone marrow transplantation in the treatment of non-Hodgkin's lymphoma. However, there are many unanswered questions as to the role of high-dose therapy in certain subtypes of lymphoma, the timing of transplant, and even the type of transplant to perform. An attempt will be made to clarify many of these unanswered questions. The utilization of high-dose therapy for non-Hodgkin's lymphoma is recommended for most patients who have relapsed after initial therapy. Transplantation in first remission is not recommended routinely. Allogeneic bone marrow transplantation should by reserved for individuals with poorly responding disease or in individuals with bone marrow involvement. The precise roles of purging and transplantation of individuals with low grade lymphoma are being investigated.
大剂量化疗和干细胞救援(骨髓移植)在恶性疾病的治疗中应用越来越广泛。众多试验已证明骨髓移植在治疗非霍奇金淋巴瘤方面的有效性。然而,关于大剂量疗法在某些淋巴瘤亚型中的作用、移植时机,甚至移植类型等问题,仍有许多未解之谜。本文将尝试阐明其中许多未解问题。对于大多数初始治疗后复发的患者,推荐使用大剂量疗法治疗非霍奇金淋巴瘤。一般不建议在首次缓解期进行移植。异基因骨髓移植应保留给疾病反应不佳或有骨髓受累的个体。目前正在研究清除低级别淋巴瘤个体的肿瘤细胞以及进行移植的确切作用。