A pilot study of a response oriented chemotherapeutic regimen combined with autologous peripheral blood progenitor cell transplantation in aggressive non-Hodgkin's lymphoma.
A pilot study of a response oriented chemotherapeutic regimen combined with autologous peripheral blood progenitor cell transplantation in aggressive non-Hodgkin's lymphoma.
复制标题
以反应为导向的化疗方案联合自体外周血祖细胞移植治疗侵袭性非霍奇金淋巴瘤的初步研究。
DOI：
10.3109/10428199909050961
复制
发表时间：
1999
影响因子：
2.6
通讯作者：
T. Koike
中科院分区：
文献类型：
--
作者：
T. Tarumi;K. Sawada;K. Koizumi;H. Takano;Y. Fukada;M. Nishio;T. Fujie;K. Ohnishi;M. Kohno;N. Sato;S. Sekiguchi;T. Koike
连续 14 名患有低风险侵袭性 NHL 且患有四种危险因素之一的患者接受了以反应为导向的诱导化疗和连续高剂量化疗，然后进行自体 PBPC 移植。用 G-CSF 支持的传统 CHOP (CHOP-G) 治疗三个周期后，评估反应。对于达到完全缓解（CR）的患者，额外给予三个周期的CHOP-G，而对于部分缓解的患者，则给予另一种诱导方案，包括一些非交叉耐药药物；给予三个周期的 VIPDexa-G（依托泊苷、异环磷酰胺、顺铂和地塞米松）+/- 两个周期的 ENAP-G（米托蒽醌、依托泊苷、阿糖胞苷和泼尼松）。预定的诱导化疗后进行高剂量细胞减灭方案治疗，然后进行自体 PBPC 移植。经过三个周期的 CHOP-G 治疗后，4 名患者 (29%) 达到 CR，10 名患者 (71%) 达到部分缓解 (PR)。当所有预定的诱导治疗完成后，10 名患者 (71%) 达到 CR。除一名移植后两个月骨髓复发外，所有 14 名患者均接受了高剂量治疗，并获得了完全的血液学恢复。高剂量治疗后的反应评估显示 12 例 CR（86%），其中包括 3 例额外 CR、1 例 PR 和 1 例毒性相关死亡。中位随访时间为 12 个月（范围为 4 至 40 个月），其中 12 例存活，其中 11 例连续首次 CR，1 例复发。 2年总生存（OS）率和无事件生存（EFS）率分别为77%和79%，无病生存（DFS）率为92%。总之，这项试点研究表明，以反应为导向的诱导化疗和连续高剂量化疗后进行自体 PBPC 移植是值得赞扬的，并且对于患有侵袭性 NHL 的低风险受试者来说，可以与高缓解率和 DFS 相关。
Fourteen consecutive patients with poor-risk aggressive NHL who at presentation had any one of four risk factors underwent response oriented induction chemotherapy and successive high-dose chemotherapy followed by autologous PBPC transplantation. After treatment with three cycles of conventional CHOP with G-CSF support (CHOP-G), the response was evaluated. For patients who achieved a complete remission (CR), an additional three cycles of CHOP-G were administered, while for partial response patients, another induction regimen including some non-cross-resistant agents was given; three cycles of VIPDexa-G (etoposide, ifosfamide, cisplatinum and dexamethasone) +/- two cycles of ENAP-G (mitoxantrone, etoposide, cytosine arabinoside and prednisone), were given. The scheduled induction chemotherapy, was followed by treatment with a high-dose cytoreductive regimen followed by autologous PBPC transplantation. After three cycles of CHOP-G, four patients (29%) achieved a CR, and 10 (71%) achieved a partial response (PR). When all scheduled induction therapy was completed, 10 patients (71%) had a CR. All 14 patients received high-dose therapy and obtained a complete hematologic recovery, except for one with a bone marrow relapse two months after transplantation. Evaluation of response after high-dose therapy showed 12 CRs (86%) which included three additional CRs, one PR, and one toxicity-related death. With a median follow-up of 12 months (range, 4 to 40), 12 are alive, with 11 in continuous first CR, and one relapse. The 2-year overall survival (OS) rate and event-free survival (EFS) rate are 77% and 79%, respectively, while the disease-free survival (DFS) rate is 92%. In conclusion, this pilot study suggests that response oriented induction chemotherapy and successive high-dose chemotherapy followed by autologous PBPC transplantation is commendable and can be associated with a high rate of remission and DFS for poor risk subjects with aggressive NHL.