TREATMENT OF MALIGNANT-LYMPHOMA IN 100 PATIENTS WITH CHEMOTHERAPY, TOTAL-BODY IRRADIATION, AND MARROW TRANSPLANTATION
TREATMENT OF MALIGNANT-LYMPHOMA IN 100 PATIENTS WITH CHEMOTHERAPY, TOTAL-BODY IRRADIATION, AND MARROW TRANSPLANTATION
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DOI：
10.1200/jco.1987.5.9.1340
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发表时间：
1987-09-01
影响因子：
45.3
通讯作者：
THOMAS, ED
中科院分区：
文献类型：
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作者：
APPELBAUM, FR;SULLIVAN, KM;THOMAS, ED
1970年7月至1985年1月，对100例恶性淋巴瘤患者进行了大剂量放化疗和骨髓移植治疗。100例中有28例存活，移植后5年无病生存率为22%。治疗失败的最常见原因是疾病复发，其概率为60%。比例风险回归分析表明，无病生存的可能性较小，在耐药复发移植的患者和那些以前接受胸部放疗。疾病组织学（霍奇金病、高度恶性淋巴瘤或中度恶性淋巴瘤）和骨髓来源（同基因、同种异体或自体）均不显著影响无病生存率或复发概率。对于在初始联合化疗后病情进展的年轻播散性恶性淋巴瘤患者，使用大剂量放化疗和骨髓移植似乎比任何其他形式的治疗提供了更好的长期生存机会。骨髓移植的最佳结果是在早期复发或第二次缓解的患者中获得的，这些患者以前没有接受过胸部放疗。
Between July 1970 and January 1985, 100 patients with malignant lymphoma were treated with high-dose chemoradiotherapy and bone marrow transplantation. Twenty-eight of the 100 are alive and the actrarial probability of disease-free survival 5 years from transplantation is 22%. The most common reason for treatment failure was disease recurrence, with an actrarial probability of 60%. A proportional hazards regression analysis showed that the likelihood of disease-free survival was less in those patients transplanted in resistant relapse and in those previously treated with chest radiotherapy. Neither disease histology (Hodgkin''s disease, high-grade lymphoma or intermediate-grade lymphoma), nor source of marrow (syngeneic, allogeneic, or autologous) significantly influenced with disease-free survival or probability of relapse. The use of high-dose chemoradiotherapy and marrow transplantation appears to offer a better chance for long-term survival than any other form of therapy for young patients with disseminated malignant lymphoma whose disease has progressed after initial combination chemotherapy. The best results with marrow transplantation were obtained in patients transplanted in early relapse or second remission who had not received prior chest radiotherapy.