Busulfan and cyclophosphamide as a preparative regimen for allogenic blood and marrow transplantation in patients with non-Hodgkins lymphoma
Busulfan and cyclophosphamide as a preparative regimen for allogenic blood and marrow transplantation in patients with non-Hodgkins lymphoma
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DOI：
10.1038/sj.bmt.1703790
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发表时间：
2003-01-01
影响因子：
4.8
通讯作者：
Lipton, JH
中科院分区：
文献类型：
--
作者：
Kiss, TL;Panzarella, T;Lipton, JH
本研究报告了 37 名连续低度和中度 NHL 患者的总生存期和无复发生存期（OS 和 RFS），这些患者使用非辐射准备方案接受相关供体同种异体 BMT。此外，还讨论了移植相关的毒性和影响结果的因素。准备方案包括白消安和环磷酰胺。患者中位年龄为 44 岁（范围 20-55 岁）。总共有 18 名女性。 BMT 存活患者的中位随访时间为 4.2 年。共有 25 名患者患有低度 NHL，12 名患者患有中度 NHL。大多数患者 (89%) 在 BMT 之前接受了至少两种不同的化疗方案。总共有 22 名患者（59%）在部分缓解时接受了移植，15 名患者（41%）在完全缓解时接受了移植。 12 个月时的 OS 为 89%（95% 置信区间 (CI) 为 79-99%），60 个月时的 OS 为 79% (64-93%)。 12 个月时的 RFS 为 86% (75-97%)，5 年时为 70% (54-86%)。 4 名患者（11%）复发。 7 名患者 (19%) 死亡，其中 6 名患者死于治疗相关毒性，1 名患者复发。单变量分析显示，年轻患者和女性患者的 OS 有所改善，这表明使用白消安-环磷酰胺作为准备方案的同种异体 BMT 可以实现疾病控制，并可能治愈 NHL 患者，特别是年轻患者。
This study reports on overall and recurrence-free survival (OS and RFS) of 37 consecutive patients with low- and intermediate-grade NHL receiving a related donor allogeneic BMT using a nonradiation-containing preparative regimen. In addition, transplant-related toxicity and factors influencing outcome are discussed. The preparative regimen consisted of busulfan and cyclophosphamide. Median patient age was 44 years (range 20-55). In all, 18 were female. Median follow-up of surviving patients from BMT was 4.2 years. A total of 25 patients had low-grade, and 12 intermediate grade NHL. Most patients (89%) were treated with at least two different chemotherapy regimens prior to BMT. In all, 22 patients (59%) were transplanted in partial remission, 15 (41%) in complete remission. OS at 12 months was 89% (95% confidence interval (CI) of 79-99%) and 79% (64-93%) at 60 months. RFS at 12 months was 86% (75-97%) and at 5 years 70% (54-86%). Four patients (11%) relapsed. Seven patients (19%) died, six because of treatment-related toxicity and one with relapse. Univariate analysis showed improved OS for younger patients and patients of female gender, suggesting that allogeneic BMT using busulfan-cyclophosphamide as a preparative regimen can achieve disease control and possibly cure patients with NHL particularly younger ones.