CYTOKINES AND STEM CELL TRANSPLANTATION FOR REFRACTORY LYMPHOMAS

现代化疗治愈了大多数霍奇金病患者 和中等级别的非霍奇金淋巴瘤。然而，标准剂量 化疗对于不能达到治疗目的的患者来说很少治愈。 完全缓解到诱导化疗或其初始完全缓解 缓解期不到12个月。大剂量化疗和 自体骨髓移植已经能够实现更长的时间 其中一些患者的病情持续完全缓解。有一种明确的 需要提高骨髓和外周血的比率 在这些患者中使用的清髓方案后，计数恢复 治疗。在这项研究中，霍奇金氏病和非霍奇金氏病患者 淋巴瘤可以通过联合化疗来清除。那些病人 达到完全缓解，或90%部分缓解，获得 大剂量ICE化疗(异环磷酰胺、卡铂、依托泊苷) 养生法。作为干细胞的来源，无论是骨髓还是外周血 将会使用血液。在采集外周血和骨之前 骨髓，患者将接受IL-1β和G-CSF。在大剂量服用后 化疗和这些干细胞，患者将获得额外的 粒细胞集落刺激因子。已有6名患者登记。有一名患者没有入选 由于淋巴瘤累及骨髓，一名患者死于 与治疗相关的毒性；一名患者评估疗效还为时过早 接受治疗，三名患者仍处于完全缓解状态。

Modern chemotherapy cures the majority of patients with Hodgkin's disease and intermediate grade non-Hodgkin's lymphomas. However, standard dose chemotherapy is rarely curative for patients who fail to achieve a complete remission to induction chemotherapy or whose initial complete remission lasts less than 12 months. Highdose chemotherapy and autologous bone marrow transplantation have been able to achieve longer lasting complete remissions in some of these patients. There is a clear need for improving the rates at which bone marrow and peripheral blood counts recover following the myeloablative regimens used in these treatments. In this study, patients with Hodgkin's and non-Hodgkin's lymphoma are debulked with combination chemotherapy. Those patients achieving a complete remission, or 90% partial remission, receive high-dose chemotherapy with the ICE (ifosfamide, carboplatin, etoposide) regimen. As a source of stem cells, both bone marrow and peripheral blood will be used. Prior to harvesting peripheral blood and bone marrow, patients will receive IL-1beta and G-CSF. Following high-dose chemotherapy and these stem cells, patients will receive additional G-CSF. Six patients have been registered. One patient was not enrolled because of bone marrow involvement with lymphoma; one patient died from treatment-related toxicity; one patient is too early to evaluate response to therapy and three patients remain in a complete remission.