Sequential high-dose therapy with peripheral-blood progenitor-cell support in low-grade non-Hodgkin's lymphoma.
Sequential high-dose therapy with peripheral-blood progenitor-cell support in low-grade non-Hodgkin's lymphoma.
复制标题
外周血祖细胞支持的序贯高剂量治疗低度恶性非霍奇金淋巴瘤。
DOI：
10.1200/jco.1994.12.8.1685
复制
发表时间：
1994
期刊：
影响因子：
--
通讯作者：
W. Hunstein
中科院分区：
文献类型：
--
作者：
Rainer Haas;M. Moos;A. Karcher;R. Möhle;B. Witt;Hartmut Goldschmidt;S. Frühauf;Michael Flentje;M. Wannenmacher;W. Hunstein
目的
评估外周血祖细胞 (PBPC) 支持序贯高剂量治疗滤泡性淋巴瘤患者的可行性。
患者和方法
自 1991 年 7 月以来，我们在研究中纳入了 30 名患者（17 名男性和 13 名女性），中位年龄为 41 岁（范围为 26 至 55 岁）。在研究开始时，17 名患者处于第一缓解期，6 名患者处于第二次或更高缓解期。另外六名患者疾病复发，一名患者肿瘤进展。 PBPC是在高剂量阿糖胞苷(ara-C)/米托蒽醌(HAM)后非格司亭支持的白细胞恢复过程中收集的。
结果
两次白细胞去除术的中位数（范围为 1 至 7）导致中位数为 5.7 x 10(6) CD34+ 细胞/kg（范围为 2.9 至 23.7 x 10(6)。在自体移植物中未检测到独特的 B 淋巴祖细胞群 (CD34+/CD19+)，并且 CD19+ B 细胞的含量非常低，中位数为对 0.07% 的单核细胞进行 bcl-2/免疫球蛋白 H (IgH) 易位的主要断点区域 (MBR) 检测，22 名患者的自体移植物呈 t(14;18) 易位阳性，而 7 名患者的自体移植物无法评估清髓治疗后，在没有细胞因子支持的情况下血液学恢复很快。达到血小板计数 > 或 = 20 x 10(9)/L 和中性粒细胞计数 > 或 = 0.5 x 10(9)/L 的中位时间分别为 11 天和 13 天，中位随访时间 6 个月后，29 名患者处于缓解状态（范围为 1 至 18 名）。 t(14;18) 阳性收获中，11 名患者在移植后 16 个月内在骨髓和/或外周血中具有 PCR 可检测的细胞，相比之下，6 名患者在回输后 3 至 16 个月内变为 PCR 阴性，其余 5 名患者的后续检查的 PCR 数据尚未获得。
结论
自体移植 PCR 阳性收获物的患者转为 PCR 阴性表明清髓方案是有效的，并且任何回输的 t(14;18) 阳性细胞可能无法持续。由于传统化疗无法治愈，我们认为应探索包括全身照射 (TBI) 在内的高剂量治疗，以治疗这些对放射特别敏感的淋巴瘤。
PURPOSE
To evaluate the feasibility of a sequential high-dose therapy with peripheral-blood progenitor-cell (PBPC) support in patients with follicular lymphoma.
PATIENTS AND METHODS
Since July 1991, we have included 30 patients (17 men and 13 women) with a median age of 41 years (range, 26 to 55) in the study. At the time of study entry, 17 patients were in first and six in second or higher remission. Another six patients had relapse of disease and one had tumor progression. PBPC were collected during filgrastim-supported leukocyte recovery following high-dose cytarabine (ara-C)/mitoxantrone (HAM).
RESULTS
A median of two leukaphereses (range, one to seven) resulted in a median of 5.7 x 10(6) CD34+ cells/kg (range, 2.9 to 23.7 x 10(6). A distinct population of B-lymphoid progenitors (CD34+/CD19+) was not detectable in the autografts, and the content of CD19+ B cells was remarkably low, comprising a median of 0.07% of the mononuclear cells. Using the polymerase chain reaction (PCR) assay for the major breakpoint regions (MBR) of the bcl-2/immunoglobulin H (IgH) translocation, 22 patients had autografts positive for the t(14;18) translocation, whereas seven patients had PCR-negative transplants. The autograft of one patient could not be assessed. Following myeloablative therapy, hematologic recovery was rapid without cytokine support. The median times to reach a platelet count > or = 20 x 10(9)/L and neutrophil count > or = 0.5 x 10(9)/L were 11 and 13 days, respectively. Nonhematologic toxicity was moderate. Twenty-nine patients were alive in remission after a median follow-up duration of 6 months (range, 1 to 18). Of 22 patients autografted with t(14;18)-positive harvests, 11 had PCR-detectable cells in bone marrow and/or peripheral blood as long as 16 months posttransplantation. In contrast, six patients became PCR-negative between 3 and 16 months after reinfusion. Follow-up examinations with PCR data for the remaining five patients are not yet available.
CONCLUSION
Conversion to PCR negativity in patients autografted with PCR-positive harvests suggests that the myeloablative regimen is effective and that any reinfused t(14;18)-positive cells may not be sustained. Because conventional chemotherapy provides no cure, we believe that high-dose therapy including total-body irradiation (TBI) should be explored in these particularly radiosensitive lymphomas.
登录
查看更多内容
自体骨髓移植治疗 B 细胞非霍奇金淋巴瘤：100 名敏感复发患者的治疗相关死亡率非常低。
DOI：
10.1200/jco.1990.8.5.784
发表时间：
1990
期刊：
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
影响因子：
--
作者：
Freedman,AS;Takvorian,T;Anderson,KC;Mauch,P;Rabinowe,SN;Blake,K;Yeap,B;Soiffer,R;Coral,F;Heflin,L
通讯作者：
Heflin,L
乳腺癌或神经母细胞瘤患者输注 CD34+ 骨髓细胞后的植入。
影响因子：
20.3
作者：
Berenson,RJ;Bensinger,WI;Hill,RS;Andrews,RG;Garcia-Lopez,J;Kalamasz,DF;Still,BJ;Spitzer,G;Buckner,CD;Bernstein,ID
通讯作者：
Bernstein,ID
通过聚合酶链反应检测 bcl-2 易位残留细胞与 B 细胞淋巴瘤自体骨髓移植后复发风险增加相关。
影响因子：
20.3
作者：
Gribben,JG;Neuberg,D;Freedman,AS;Gimmi,CD;Pesek,KW;Barber,M;Saporito,L;Woo,SD;Coral,F;Spector,N
通讯作者：
Spector,N
影响因子：
56.9
作者：
TSUJIMOTO, Y;GORHAM, J;CROCE, CM
通讯作者：
CROCE, CM
自体骨髓移植治疗淋巴恶性肿瘤后重组人粒细胞-巨噬细胞集落刺激因子的 III 期研究的长期随访。
影响因子：
20.3
作者：
Rabinowe,SN;Neuberg,D;Bierman,PJ;Vose,JM;Nemunaitis,J;Singer,JW;Freedman,AS;Mauch,P;Demetri,G;Onetto,N
通讯作者：
Onetto,N