Pulmonary toxicity following carmustine-based preparative regimens and autologous peripheral blood progenitor cell transplantation in hematological malignancies
Pulmonary toxicity following carmustine-based preparative regimens and autologous peripheral blood progenitor cell transplantation in hematological malignancies
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DOI：
10.1038/sj.bmt.1702154
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发表时间：
2000-02-01
影响因子：
4.8
通讯作者：
Bernasconi, C
中科院分区：
文献类型：
--
作者：
Alessandrino, EP;Bernasconi, P;Bernasconi, C
65例血液恶性肿瘤患者（25例多发性骨髓瘤，18例霍奇金病，22例非霍奇金淋巴瘤）接受卡莫司汀为基础的方案，然后进行自体PBPC移植，进行了回顾性研究，以评估移植后非感染性肺部并发症（NIPC）的发生率，预测NIPC的危险因素，以及对类固醇的反应。卡莫司汀（BCNU）600 mg/m2静脉注射，40例患者（BCV方案）与依托泊苷和环磷酰胺联合治疗，25例患者（BEM方案）与依托泊苷和美法仑联合治疗。65例患者中17例（26%）有1次NIPC发作，中位时间90天（52-289天）。多因素分析显示，女性（P < 0.001）和BCV方案（P < 0.05）是NIPC发生的危险因素。所有NIPC患者均接受泼尼松治疗，剂量为1 mg/kg体重，连续10天，然后每两天减少5 mg，17例患者中有15例对类固醇完全反应; 1例无反应患者死于间质性肺炎，BCNU 600 mg/m2与美法仑和依托泊苷联合给药耐受性良好，在女性和接受BCNU和环磷酰胺的患者中，建议减少BCNU剂量。
Sixty-five patients with hematological malignancies (25 multiple myeloma, 18 Hodgkin's disease, 22 non-Hodgkin's lymphomas) who received a carmustine-based regimen followed by autologous PBPC transplantation, were studied retrospectively to evaluate the incidence of post-transplant non-infective pulmonary complications (NIPCs), risk factors predictive of NIPCs, and response to steroids. Carmustine (BCNU) given i.v, at a dose of 600 mg/m(2) was combined with etoposide and cyclophosphamide in 40 patients (BCV regimen) and with etoposide and melphalan in 25 patients (BEM regimen). Seventeen of 65 patients (26%) had one episode of NIPCs, The median time to NIPCs was 90 days (52-289). Factors that increased the risk of developing NIPCs on multivariate analysis were female sex (P < 0.001) and BCV regimen (P < 0.05). All patients with NIPCs received prednisone at a dose of 1 mg/kg body weight for 10 days then tapered by 5 mg every two days; complete response to steroids was achieved in 15 of 17 patients; one unresponsive patient died of interstitial pneumonia, BCNU given at the dose of 600 mg/m(2) is well tolerated when associated with melphalan and etoposide, In females and in patients receiving BCNU with cyclophosphamide, a BCNU dose reduction may be advisable.