期刊
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
卷 13, 期 9, 页码 1057-1065出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2007.05.012
关键词
autologous; bone marrow transplantation; follicular lymphoma; first remission purging; PCR
资金
- NCI NIH HHS [K23 CA115682-03, P01 CA092625, K23 CA115682, P01 CA092625-07, CA34183, 2P01CA092625, P01 CA092625-05] Funding Source: Medline
The role of autologous stem cell transplantation (ASCT) in the treatment of follicular lymphoma is still being defined in the era of antibody therapy. Here we report the long-term 12-year clinical outcomes of patients treated with autologous bone marrow transplantation (ABMT) for follicular non-Hodgkin's lymphoma (NHL) in first remission. Between 1988 and 1993, advanced-stage follicular NHL patients in need of initial therapy were enrolled in 2 consecutive prospective treatment trials of either standard-dose CHOP induction (83 patients) or high-dose CHOP plus granulocyte-colony stimulating factor (G-CSF) (20 patients). Patients who achieved an adequate remission with induction therapy underwent conditioning with cyclophosphamide and total body irradiation (TBI) followed by ABMT in first remission using bone marrow (BM) purged in vitro with anti-B cell monoclonal antibodies and rabbit complement (96 patients). At 12-year follow-up, 61% of the patients are alive and 43% remain in continuing complete remission. The only predictors of decreased progression-free survival proved to be histologic BM involvement at time of harvest (hazard ratio [HR] 2.27, 95% confidence interval [CI] 1.3-3.9, P <.004) and PCR detectable disease in the BM product after purging (HR 4.18, 95% CI 1.99-8.8, P = .0002). No significant predictors of overall survival were identified. These results at 12-year follow-up suggest that a subset of follicular lymphoma patients can experience prolonged survival with ABMT in first remission. (c) 2007 American Society for Blood and Marrow Transplantation
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