Management of Hodgkin lymphoma in relapse after autologous stem cell transplant.
Management of Hodgkin lymphoma in relapse after autologous stem cell transplant.
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DOI：
10.1182/asheducation-2008.1.326
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发表时间：
2008-01-01
期刊：
影响因子：
--
通讯作者：
Crump, Michael
中科院分区：
文献类型：
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作者：
Crump, Michael
霍奇金淋巴瘤（HL）复发发生在自体干细胞移植（ASCT）后约50%的患者中，通常在第一年内，代表了一个重大的治疗挑战。在这种情况下，复发性HL的自然病程可能从快速进展到更缓慢的病程。这种情况下的患者通常很年轻，没有合并症，能够耐受额外的治疗：期望值通常仍然很高。治疗方法取决于临床变量（复发时间、对额外细胞毒性治疗的感知敏感性、疾病分期）、既往放射治疗史、HLA相同供体的可用性以及通过临床试验获得的新药。虽然这些患者中很少有可以治愈的，但报告系列的结果（尽管通常较小，有时随访时间相对较短）表明，通过放疗、单药或多药化疗和降低强度的同种异体移植可以实现良好的疾病控制。这些方法的结果将进行审查，并将讨论纳入使用标准或研究药物或方法的治疗算法。
Recurrence of Hodgkin lymphoma (HL) occurs in about 50% of patients after autologous stem cell transplantation (ASCT), usually within the first year, and represents a significant therapeutic challenge. The natural history of recurrent HL in this setting may range from a rapidly progressive to a more indolent course. Patients in this setting are often young, without comorbidities and able to tolerate additional therapies: expectations are often still high. The approach to treatment depends on clinical variables (time to relapse, perceived sensitivity to additional cytotoxic therapy, disease stage), prior history of radiation therapy, the availability of an HLA-identical donor, and the availability of new agents via clinical trials. Although very few of these patients can be cured, results from reported series, albeit often small and sometimes with relatively short follow-up, document that excellent disease control can be achieved with radiation, single or multiagent chemotherapy, and reduced-intensity allogeneic transplantation. The results of these approaches will be reviewed, and a treatment algorithm incorporating the use of standard or investigational agents or approaches will be discussed.