Pavletic Z S, Bierman P J, Vose J M, Bishop M R, Wu C D, Pierson J L, Kollath J P, Weisenburger D D, Kessinger A, Armitage J O
Department of Internal Medicine, University of Nebraska Medical Center, Omaha, USA.
Ann Oncol. 1998 Sep;9(9):1023-6. doi: 10.1023/A:1008474526373.
High-dose therapy followed by autologous stem-cell transplantation (autoSCT) induces complete remissions in the majority of patients with advanced B-cell chronic lymphocytic leukemia or small lymphocytic lymphoma (B-CLL). However, the long-term utility of this therapy for B-CLL is unknown.
Sixteen previously treated patients with B-CLL were transplanted using autologous blood (n = 13) or bone marrow (n = 3). The median age of the patients was 49 f1p4s (range 44-60 years), and the median number of prior chemotherapy regimens was two. Patients were eligible for transplantation if they had chemosensitive disease and no morphologic evidence of malignant cells in the graft. Preparative regimens included cyclophosphamide and total-body-irradiation, with or without cytarabine, or BEAC.
All patients engrafted and achieved a complete remission posttransplant. Ten patients were alive at a median of 41 months (range 22-125 months), and five were disease-free. Eight patients have relapsed and six have died (three from progressive malignancy). The projected three-year overall survival, failure-free survival and relapse rates were 68%, 37%, and 56%, respectively.
AutoSCT for advanced B-CLL is associated with a high relapse rate. Whether this therapy can prolong life or produce cures is uncertain.
大剂量治疗后进行自体干细胞移植（autoSCT）可使大多数晚期B细胞慢性淋巴细胞白血病或小淋巴细胞淋巴瘤（B-CLL）患者获得完全缓解。然而，这种疗法对B-CLL的长期效用尚不清楚。
16例先前接受过治疗的B-CLL患者接受了自体血（n = 13）或骨髓（n = 3）移植。患者的中位年龄为49岁（范围44 - 60岁），先前化疗方案的中位次数为两次。如果患者患有化疗敏感疾病且移植物中无恶性细胞的形态学证据，则有资格进行移植。预处理方案包括环磷酰胺和全身照射，加或不加阿糖胞苷，或BEAC。
所有患者均成功植入并在移植后获得完全缓解。10例患者存活，中位生存期为41个月（范围22 - 125个月），5例无病生存。8例患者复发，6例死亡（3例死于进行性恶性肿瘤）。预计三年总生存率、无失败生存率和复发率分别为68%、37%和56%。
晚期B-CLL的自体干细胞移植复发率高。这种疗法能否延长生命或实现治愈尚不确定。
