Morbidity and transplant-related mortality of CBV and BEAM preparative regimens for patients with lymphoid malignancies undergoing autologous stem-cell transplantation
Morbidity and transplant-related mortality of CBV and BEAM preparative regimens for patients with lymphoid malignancies undergoing autologous stem-cell transplantation
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DOI：
10.1080/10428190500527769
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发表时间：
2006-08-01
影响因子：
2.6
通讯作者：
Sanz, Miguel A.
中科院分区：
文献类型：
--
作者：
Puig, Noemi;De La Rubia, Javier;Sanz, Miguel A.
CBV和BEAM是接受自体造血干细胞移植（ASCT）的淋巴瘤患者最常用的两种方案。本研究比较了1990 - 2004年间113例接受ASCT的非霍奇金淋巴瘤（69例）和霍奇金病（44例）的发病率和移植相关死亡率（TRM）。CBV(环磷酰胺，6000 mg m(-2)；VP- 16,750 mg m(-2)；75例患者给予高剂量BCNU， 800 mg m72)， 38例患者接受BEAM （BCNU, 300 mg m72; VP- 16, 800 mg m72；阿糖胞苷，800 mg m72；美伐兰，140 mg m(-2)）。BEAM组患者的中位年龄显著增高（p = 0.002）， ASCT前接受的治疗更重（p = 0.003）。BEAM组移植时出现活动性疾病的患者较多（p < 0.04）。窦状窦梗阻综合征（SOS）在CBV组更为常见（11% vs 0%, p = 0.048）。移植相关死亡20例（18%），CBV组18例，BEAM组2例。感染并发症（12例，7例为肺炎）和SOS（4例）是最常见的死亡原因。CBV组TRM的累计发生率为25%，BEAM组为7% （p = 0.02）。因此，CBV在本系列中产生的SOS和TRM发生率高于BEAM。
CBV and BEAM are the two most frequently used regimens for patients with lymphoma undergoing autologous hematopoietic stem-cell transplantation ( ASCT). This study compared their morbidity and transplant- related mortality ( TRM) in 113 patients with non-Hodgkin's lymphoma ( 69) and Hodgkin's disease (44) undergoing ASCT between 1990 - 2004. CBV ( cyclophosphamide, 6000 mg m(-2); VP- 16, 750 mg m(-2); and high- dose BCNU, 800 mg m72) was administered to 75 patients and 38 received BEAM ( BCNU, 300 mg m72; VP- 16, 800 mg m72; cytarabine, 800 mg m72; melphalan, 140 mg m(-2)). Patients in the BEAM group had a significantly higher median age (p = 0.002) and were more heavily treated before ASCT (p = 0.003). More patients showed active disease at transplant in the BEAM group (p < 0.04). Sinusoidal obstruction syndrome ( SOS) was more frequent in the CBV group (11% vs 0%, p = 0.048). There were 20 (18%) transplantrelated deaths, 18 in the CBV and two in the BEAM group. Infectious complications ( 12 patients, seven with pneumonia) and SOS ( four) were the most frequent causes of death. The cumulative incidences of TRM were 25% in the CBV and 7% in the BEAM group ( p = 0.02). CBV thus produced a higher incidence of SOS and TRM than BEAM in this series.