MARROW TRANSPLANTATION FOR PATIENTS WITH LYMPHOMA

项目2所述研究的总体目标是改善 骨髓移植的结局 治疗淋巴恶性肿瘤，包括急性淋巴细胞性 白血病（ALL）、恶性淋巴瘤和多发性骨髓瘤。 患者 未接受剂量限制性治疗的ALL和恶性淋巴瘤 放射治疗，重组α干扰素的毒性和疗效 在环磷酰胺和全身准备方案后给予 将对辐射进行评估。 这项研究是基于以前的一项研究。 一项随机试验表明，非重组干扰素减少了50%， ALL患者移植后复发的发生率。 患者 ALL和恶性淋巴瘤患者， 放射治疗，并试图减少毒性的一个 卡莫司汀、环磷酰胺和依托泊苷的制备方案， 添加戊茶碱。 在多发性骨髓瘤患者中， 在疾病的早期进行骨髓移植， 探索并开发了新的制备方案。 在“早期”患者中， 包括那些在初步反应后具有不良风险因素的人， 患有复发性疾病但肿瘤负荷较低，白消安试验， 将进行环磷酰胺和同种异体骨髓移植。 在晚期疾病患者中，一种新的治疗方法， 使用标准186 Re-HEDP进行生化靶向放射治疗 将评估白消安/环磷酰胺方案。

The overall goal of the studies described in Project 2 is to improve the outcome of allogeneic marrow transplantation from matched family members in the treatment of lymphoid malignancies, including acute lymphocytic leukemia (ALL), malignant lymphoma and multiple myeloma. In patients with ALL and malignant lymphoma who have not received dose-limiting radiotherapy, the toxicity and efficacy of recombinant alpha interferon given after a preparative regimen of cyclophosphamide and total body irradiation will be evaluated. This study is based on a previous randomized trial which showed that nonrecombinant interferon reduced by 50% the incidence of posttransplant relapse in patients with ALL. In patients with ALL and malignant lymphoma who have received dose-limiting radiotherapy, and attempt will be made to reduce the toxicity of a preparative regimen of carmustine, cyclophosphamide and etoposide with the addition of pentoxifylline. In patients with multiple myeloma the use of marrow transplantation earlier in the course of the disease will be explored and new preparative regimens developed. In "early" patients, including those with poor risk factors after initial response and those with relapsed disease but a low tumor burden, a trial of busulfan, cyclophosphamide and allogeneic marrow transplantation will be performed. In patients with advanced disease, a new treatment approach which combines biochemically targeted radiotherapy using 186Re-HEDP with a standard busulfan/cyclophosphamide regimen will be evaluated.