Role of a second transplant in the management of poor-prognosis lymphomas: a report from the European Blood and Bone Marrow Registry.
Role of a second transplant in the management of poor-prognosis lymphomas: a report from the European Blood and Bone Marrow Registry.
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第二次移植在治疗不良预后淋巴瘤中的作用：欧洲血液和骨髓登记处的报告。
DOI：
10.1200/jco.1997.15.4.1595
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
Ah Goldstone
中科院分区：
文献类型：
--
作者：
Elisabeth Vandenberghe;Rachel M. Pearce;G. Taghipour;L. Fouillard;Ah Goldstone
目的
选择预后不良的淋巴瘤患者，采用大剂量化疗和骨髓或外周干细胞挽救治疗可改善预后。第二个疗程的清髓性化疗已给予一些患者，但很少有数据的适应症，发病率和总生存率与这种方法。这项研究的目的是评估发病率，并确定可能从第二次移植中受益的患者亚组。
患者和方法
34例淋巴瘤患者接受了两个周期的清髓性化疗，并在1982年至1995年期间进入欧洲血液和骨髓移植（EBMT）登记处：霍奇金病（HD），n = 12;中度/高度非霍奇金淋巴瘤（HG-NHL），n = 17;低度非霍奇金淋巴瘤（LG-NHL），n = 5。评估第二次移植的原因、移植时的状态、预处理方案、发病率以及无进展生存期（PFS）和总生存期（OS）。
结果
第二次手术的原因如下：（1）4例患者选择性双手术，（2）20例首次移植后复发，（3）8例首次移植后部分缓解（PR），（4）2例首次移植后难治性疾病。接受两次移植的患者的2年OS率（从第二次移植之日起估计）为49%，中位随访时间为44个月。按组织学亚型划分的2年OS率如下：HD，50%; HG-NHL，60%; LG-NHL，0%。15例HD或HG-NHL患者中有7例在移植后完全缓解（CR）后复发，在第二次移植后13至36个月仍处于CR状态，而10例CR患者中有2例（第二次移植后6和19个月）在第一次移植后达到PR或患有难治性疾病。3个月前有8例死亡（24%），其中3例（9%）与移植有关，其余的是由于持续性疾病。发生了3例晚期中毒性死亡：2例心血管疾病，1例继发性白血病。
结论
选择HD和HG-NHL患者，其疾病在一次移植后复发，可能会从第二次移植中受益。患有难治性疾病和LG-NHL的患者没有从第二次移植中获益。
PURPOSE
Treatment of selected patients with poor-prognosis lymphomas with high-dose chemotherapy and marrow or peripheral stem-cell rescue improves prognosis. A second course of myeloablative chemotherapy has been given to some patients, but few data are available on the indications, morbidity, and overall survival associated with this approach. This study was undertaken to evaluate morbidity and identify subgroups of patients who may benefit from a second transplant.
PATIENTS AND METHODS
Thirty-four patients with lymphoma given two cycles of myeloablative chemotherapy and entered onto the European Blood and Bone Marrow Transplant (EBMT) registry between 1982 and 1995 were included in this study: Hodgkin's disease (HD), n = 12; intermediate/high-grade non-Hodgkin's lymphoma (HG-NHL), n = 17; and low-grade non-Hodgkin's lymphoma (LG-NHL), n = 5. The reason for second transplant, status at transplant, conditioning regimen, morbidity, and both progression-free survival (PFS) and overall survival (OS) were assessed.
RESULTS
The second procedure was performed for the following reasons: (1) elective double procedure in four patients, (2) relapse after first transplant in 20, (3) partial remission (PR) after first transplant in eight, and (4) refractory disease after first transplant in two. The OS rate at 2 years for patients who underwent two transplants (estimated from the date of second transplant) was 49%, with a median follow-up time of 44 months. The OS rate at 2 years by histologic subtype was as follows; HD, 50%; HG-NHL, 60%; and LG-NHL, 0%. Seven of 15 patients with HD or HG-NHL who relapsed after they had achieved a posttransplant complete remission (CR) remain in CR 13 to 36 months after the second transplant, compared with two of 10 patients in CR (at 6 and 19 months after second transplant) who achieved a PR or had refractory disease after the first transplant. There were eight deaths (24%) before 3 months, of which three (9%) were transplant-related and the remainder due to persistent disease. Three late toxic deaths occurred: two of cardiovascular disease and one of secondary leukemia.
CONCLUSION
Selected patients with HD and HG-NHL whose disease recurs after one transplant may benefit from a second transplant. Patients with refractory disease and LG-NHL did not benefit from a second transplant.
使用外周血祖细胞和非格司亭进行基于卡铂的化疗的同时剂量递增和时间表强化：一项 I 期试验。
影响因子：
11.2
作者：
Fennelly,D;Wasserheit,C;Schneider,J;Hakes,T;Reich,L;Curtin,J;Yao,TJ;Markman,M;Norton,L;Crown,J
通讯作者：
Crown,J
对 69 名有低度 B 细胞非霍奇金淋巴瘤病史的患者进行自体骨髓移植。
影响因子：
20.3
作者：
Freedman,AS;Ritz,J;Neuberg,D;Anderson,KC;Rabinowe,SN;Mauch,P;Takvorian,T;Soiffer,R;Blake,K;Yeap,B
通讯作者：
Yeap,B