The role of high-dose therapy and autologous hematopoietic stem cell transplantation for mantle cell lymphoma.
The role of high-dose therapy and autologous hematopoietic stem cell transplantation for mantle cell lymphoma.
复制标题
大剂量治疗和自体造血干细胞移植对套细胞淋巴瘤的作用。
作者：
D. Stewart;J. Vose;D. Weisenburger;James R. Anderson;E. Ruby;M. Bast;P. Bierman;A. Kessinger;J. Armitage
背景
尽管套细胞淋巴瘤（MCL）是一种独特的疾病实体，具有明确的临床和病理特征，但有关其治疗的信息却很少。本文将评估接受蒽环类诱导治疗或大剂量化疗以及自体造血干细胞移植治疗疾病复发的 MCL 患者。
患者和方法
对 14 名既往未经治疗的 MCL 患者的病例进行了回顾，这些患者在 3/83 至 2/92 期间接受了内布拉斯加州淋巴瘤研究组方案中含蒽环类药物的联合化疗方案。在同一时期，另一组 9 名复发性 MCL 患者被转诊接受高剂量放化疗和自体干细胞挽救作为挽救治疗。
结果
接受含蒽环类药物方案诱导治疗的患者自化疗开始起的五年总生存率 (OS) 和无失败生存率 (FFS) 分别为 23% 和 8%。截至本分析时，9 名移植患者中的 3 名在移植后 7、12 和 25 个月仍保持无进展。总共两年，所有 9 名患者的 FFS 均为 34%。
结论
需要对更多患者进行更长时间的随访，以确定高剂量治疗是否可以克服化疗耐药性并提高 MCL 的治愈率。由于大多数患有这种疾病的患者通过标准化疗治愈的机会很小，因此高剂量治疗的最佳时机可能是作为一线治疗的一部分。需要进一步的临床试验来研究高剂量治疗对 MCL 患者的潜在益处。
BACKGROUND
Although mantle cell lymphoma (MCL) is a distinct disease entity with well described clinical and pathological features, little information exists regarding its therapy. This paper will evaluate patients with MCL receiving either induction therapy with an anthracycline or high-dose chemotherapy and autologous hematopoietic stem cell transplantation for relapsed disease.
PATIENTS AND METHODS
The cases of 14 previously untreated patients with MCL who received an anthracycline-containing combination chemotherapy regimen on Nebraska Lymphoma Study Group protocols from 3/83 to 2/92 were reviewed. During the same time period, a different set of nine patients with recurrent MCL were referred for high-dose chemoradiotherapy and autologous stem cell rescue as salvage therapy.
RESULTS
The five year overall (OS) and failure-free (FFS) survivals from the initiation of chemotherapy for the patients receiving an induction therapy with an anthracycline containing regimen were 23% and 8%, respectively. At the time of this analysis, three of the nine transplant patients remain progression-free 7, 12, and 25 months post-transplant. Two year overall and FFS for all nine patients was 34%.
CONCLUSIONS
Longer follow-up of greater patient numbers is required to determine whether high-dose therapy can overcome the chemoresistance and increase the cure rate of MCL. Since most patients with this disease have minimal chance of cure with standard chemotherapy, the optimal timing for high dose therapy may be as part of front-line treatment. Further clinical trials are required to investigate the potential benefits of high-dose therapy for patients with MCL.
自体骨髓移植治疗预后不良的中度和高级 B 细胞非霍奇金淋巴瘤首次缓解：一项试点研究。
DOI：
10.1200/jco.1993.11.5.931
发表时间：
1993
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;Neuberg,D;Mauch,P;Rabinowe,SN;Anderson,KC;Soiffer,RJ;Spector,N;Grossbard,M;Robertson,MJ
通讯作者：
Robertson,MJ