AUTOGRAFTING FOR LYMPHOMA

改善治疗效果是我们研究的目标。 大剂量治疗加自体移植治疗何杰金氏病 非霍奇金淋巴瘤。我们打算通过以下方式实现这一目标 新的准备方案和移植后的研究 免疫疗法。互补的病理学研究计划更好地 定义临床结果的生物学相关性。 拟议的临床研究建立在我们之前在这些方面的研究基础上 疾病。一种新的准备方案(CCNU、VP16、环磷酰胺) 在斯坦福大学开发的药物将在患有 低风险霍奇金氏病。多周期大剂量治疗已经成为 开发用于减少高危霍奇金氏病患者的复发。 我们将比较高剂量序贯疗法的疗效和毒性。 化疗采用我们的标准准备方案，处于第三阶段 非霍奇金淋巴瘤的临床试验。关联将与一个 淋巴瘤组织中生物参数的顺序评估 进一步阐明可能预测治疗结果的因素 经过大剂量治疗和自体移植。所有自体移植患者 将通过敏感的分子和细胞遗传学技术进行研究 旨在预测基因组的不稳定性和治疗风险- 相关的骨髓发育不良或急性白血病。与 项目III中的调查人员，我们将研究可行性和 细胞因子诱导的杀伤细胞输注对慢性粒细胞白血病患者的毒性作用 难治性非霍奇金淋巴瘤。这些CIK细胞代表了一种新的 治疗，当作为高剂量治疗的辅助手段时， 自体移植，可能会减少术后复发的主要问题 自体移植。 项目II中的研究是基于过去在 研究实验室和临床。对以往经验的分析 使我们能够在霍奇金氏病和结构中定义风险组 相应的准备养生法。我们计划一个全面的方法 非霍奇金淋巴瘤的鉴别诊断研究 组织，从分离产品中清除淋巴瘤，比较两种 准备方案，并介绍了一种新的移植后 把免疫疗法带到诊所。潜在的骨髓发育不良或 急性白血病作为大剂量治疗的晚期效应将被研究 预期在所有患者中使用。项目II将作为一个临床项目 其他子项目的资源。

It is the objective of our studies to improve the results of treatment with high dose therapy and autografting in Hodgkin's disease and the non-Hodgkin's lymphomas. We intend to accomplish this goal through the study of novel preparatory regimens and post-transplant immunotherapy. Complementary pathology studies are planned to better define biologic correlates of the clinical results. The proposed clinical studies build on our previous research in these diseases. A new preparatory regimen (CCNU, VP16, cyclophosphamide) developed at Stanford University will be evaluated in patients with low risk Hodgkin's disease. Multiple cycle high dose therapy has been developed to reduce relapse in high risk Hodgkin's disease patients. We will compare the efficacy and toxicity of high dose sequential chemotherapy with our standard preparatory regimen in a Phase III trial in non-Hodgkin's lymphoma. Correlations will be made with a number of biologic parameters assessed in lymphoma tissues in order to further elucidate factors that may predict the treatment outcome after high dose therapy and autografting. All autografted patients will be studied by sensitive molecular and cytogenetic techniques designed to predict genomic instability and the risk for treatment- related myelodysplasia or acute leukemia. In collaboration with investigators in Project III, we will study the feasibility and toxicity of infusing cytokine-induced killer cells into patients with refractory non-Hodgkin's lymphoma. These CIK cells represent a novel therapeutic which, when used as an adjunct to high dose therapy and autografting, may reduce the major problem of relapse after autografting. The studies in Project II are based on past accomplishments in the research laboratory and the clinic. Analysis of previous experience allows us to define risk groups in Hodgkin's disease and structure preparatory regimens accordingly. We plan a comprehensive approach to the study of non-Hodgkin's lymphoma by characterizing lymphoma tissues, purging lymphoma from the apheresis product, comparing two preparatory regimens, and introducing a novel post-transplant immunotherapy to the clinic. The potential for myelodysplasia or acute leukemia as a late effect of high dose therapy will be studied prospectively in all patients. Project II will serve as a clinical resource for other subprojects.