MARROW TRANSPLANTATION FOR PATIENTS WITH LYMPHOMA

项目2中描述的研究的总体目标是改善 年配对家庭成员异基因骨髓移植的转归 淋巴系恶性肿瘤的治疗，包括急性淋巴细胞性肿瘤 白血病(ALL)、恶性淋巴瘤和多发性骨髓瘤。在患有 未接受剂量限制的ALL和恶性淋巴瘤 重组α-干扰素的放射治疗及其毒性和疗效 在环磷酰胺和全身准备方案后给药 将对辐射进行评估。这项研究基于之前的一项研究 显示非重组干扰素减少50%的随机试验 急性淋巴细胞白血病患者移植后复发的发生率。在病人中 接受剂量限制的ALL和恶性淋巴瘤患者 放射治疗，并将尝试减少毒性 卡莫司汀、环磷酰胺和依托泊苷的制备方案 己酮可可碱的加入物。在多发性骨髓瘤患者中使用 在病程的早期进行骨髓移植将是 探索和开发了新的制备方案。在“早期”患者中， 包括初步反应后风险因素较差的和 复发的疾病，但肿瘤负担很低，白花丹的试验， 将进行环磷酰胺和异基因骨髓移植。 在晚期疾病患者中，一种新的治疗方法 186Re-HEDP的生化靶向放射治疗 将对白消安/环磷酰胺方案进行评估。

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.