- 期刊
High Dose Chemotherapy with Peripheral Blood Stem Cells Transplantation in Patients with Relapsed or Refractory Lymphomas - Preliminary Reports
高劑量化學治療併血液幹細胞移植應用於復發或頑固性惡性淋巴瘤之臨床研究 －初報
摘要
高劑量化學治療併血液幹細胞移植之臨床應用已有十年的歷史，然而有關這方面的治療在台灣仍鮮有報告。對於復發或頑固性惡性淋巴瘤的治療，一般咸認為傳統的化學治療是無法治癒的，自高劑量化學治療併血液幹細胞植被臨床應用以來，對於這些病人又帶來一線的希望。因此本研究主要探討高劑量化治療併血液幹細胞移植應用於復發或頑固性惡性淋巴瘤之臨床效果，我們的目標主要評估血液相恢復時間，緩解率，高劑量化療副作用及存活。初步結果顯示8位復發或邧固性惡性淋巴瘤病人經高劑量化學治療及血液血液幹細胞移植後，平均於移植後第10天白血球恢復達500/µl，第12天達100/µl；而在血小板之恢復期亦即達到不需輸注血小板時期則於第14天；在高劑量化療副作用上，大部份病人只有輕度第一級到第二級的胞毒性，只有一例(12.5%)因高劑量化療副作用而於第九天死亡；七位成功植入者皆可再次地達到緩解；然而其中四例經平均天數223天復發後死亡，另外三例仍持續在緩解中。
關鍵字
無資料並列摘要
High dose chemotherapy with peripheral blood stem cells transplantation (PBSCT) has been used worldwide in the treatment of patients with various hematological ma lignancies and other solid tumors. It has just come into use as a salvage therapy in various malignancies in Taiwan in recent years. We report eight cases with relapsed or refractory lymphoma treated with high dose chemotherapy and PBSCT. Our results showed all cases but one achieved complete remission. The mean days of white cell recovery were 10 days to ＞ 500/µl (ranges, 8-16 days) and 12 days to ＞1,000/µl(ranges, 9-19 days). The mean days to platelet transfusion independent, i.e. platelet ＞ 20,000/µl, was 14 days. No specific side effect was noted except death in one case on D + 9 during cytopenia state. Four patients relapsed and died during the follow-up after PBSCT. Form our preliminary results we suggest that high dose chemotherapy with PBSCT could be used as a salvage therapy in patients with relapsed or refractory lymphomas with favorable and sustained hematological recovery. Most cases were tolerable with myeloablative chemotherapy and re-achieved remission, however, remission duration was still short and relapse remained the main problem to be overcome. The long term effects of high dose chemotherapy with PBSCT still need further study.
延伸閱讀
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