AUTOGRAFTING FOR LYMPHOMA

我们研究的目的是改善治疗效果 高剂量治疗和自体移植治疗霍奇金病， 非霍奇金淋巴瘤 我们打算通过以下方式实现这一目标： 研究新的准备方案和移植后 免疫疗法 计划进行补充病理学研究， 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以前的研究基础上， 疾病 一种新的预备方案（CCNU、VP 16、环磷酰胺） 在斯坦福大学开发的将在患者中进行评估， 低风险霍奇金病 多周期高剂量治疗已被 用于减少高危霍奇金病患者的复发。 我们将比较高剂量序贯治疗的疗效和毒性。 在III期临床试验中， 非霍奇金淋巴瘤的临床试验 相关性将与 淋巴瘤组织中评估的生物学参数数量， 进一步阐明可能预测治疗结果的因素 高剂量治疗和自体移植后。 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的风险- 相关的骨髓增生异常或急性白血病。 协同 在项目III中，我们将研究可行性， 将奎宁诱导的杀伤细胞输注到患者体内的毒性 难治性非霍奇金淋巴瘤 这些CIK细胞代表了一种新的 当用作高剂量治疗的辅助治疗时， 自体移植，可以减少复发后的主要问题， 自体移植 项目二的研究是根据过去在 研究实验室和诊所。 对以往经验的分析 使我们能够确定霍奇金病的风险群体和结构， 相应的预备方案。 我们计划采取全面的方法 通过描述淋巴瘤的特征来研究非霍奇金淋巴瘤 组织，从单采产物中清除淋巴瘤，比较两种 准备方案，并引入一种新的移植后 免疫疗法到诊所 脊髓发育不良的可能性或 将研究急性白血病作为高剂量治疗的晚期效应 在所有患者中前瞻性。 项目II将作为临床 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.