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首页> 外文期刊>Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation >Improved outcomes in intermediate- and high-risk aggressive non-Hodgkin lymphoma after autologous hematopoietic stem cell transplantation substituting intravenous for oral busulfan in a busulfan, cyclophosphamide, and etoposide preparative regimen.
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Improved outcomes in intermediate- and high-risk aggressive non-Hodgkin lymphoma after autologous hematopoietic stem cell transplantation substituting intravenous for oral busulfan in a busulfan, cyclophosphamide, and etoposide preparative regimen.

机译：自体造血干细胞移植在白消安，环磷酰胺和依托泊苷制备方案中用口服白消安替代静脉内自体造血干细胞移植后，中，高危侵袭性非霍奇金淋巴瘤的预后得到改善。

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Forty-nine patients with intermediate- and high-risk aggressive non-Hodgkin lymphoma underwent autologous hematopoietic stem cell transplantation (autoHSCT) using the regimen of busulfan (Bu), cyclophosphamide (Cy), and etoposide (E) that was originally developed for allogeneic HSCT. Eighteen patients treated before 1999 received Cy 2.5 g/m2 on days -3 to -2 and E 1800 mg/m2 on day -3 after oral (PO) administration of Bu 1 mg/kg every 6 hours x 4 days for a total of 16 doses beginning on day -7. After April 1999, 31 patients similar in all pretransplantation risk assessments received the same regimen except that intravenous (IV) Bu was substituted for PO Bu and pharmacokinetic-directed (PKD) dosing was attempted to achieve an area under the concentration time curve of 1000-1500 micromol/min for each dose. Nonrelapse mortality was 28% for PO Bu patients versus 3% for the IV PKD group (P = .01, chi-square test). Actuarial 5-year overall survivals were 28% for patients who received the PO Bu regimen and 58% for patients who received the IV Bu regimen (P = .010, log-rank test), and progression-free survivals were 17% and 50%, respectively (P = .008, log-rank test). After substitution of PKD IV Bu in the BuCyE regimen, we observed lower nonrelapse mortality with increased overall and progression-free survivals in patients with intermediate- and high-risk aggressive non-Hodgkin lymphoma who underwent autoHSCT.
机译：49例中，高危侵袭性非霍奇金淋巴瘤患者接受了原为异基因研究开发的白消安（Bu），环磷酰胺（Cy）和依托泊苷（E）方案进行了自体造血干细胞移植（autoHSCT）。 HSCT。在1999年之前接受治疗的18位患者在每6小时x 4天口服（PO）施用Bu 1 mg / kg，在第3天至第-2天接受Cy 2.5 g / m2，在第-3天接受E 1800 mg / m2，在-3天接受E 1800 mg / m2从第-7天开始16剂。 1999年4月之后，在所有移植前风险评估中相似的31名患者接受了相同的治疗方案，只是用静脉内（IV）Bu代替了PO Bu，并尝试进行药代动力学指导（PKD）剂量以达到浓度时间曲线下1000-每次剂量为1500微摩尔/分钟。 PO Bu患者的非复发死亡率为28％，而IV PKD组为3％（P = 0.01，卡方检验）。接受PO Bu方案的患者的5年精算总生存率为28％，接受IV Bu方案的患者为58％（P = .010，对数秩检验），无进展生存率为17％和50分别为％（P = 0.008，对数秩检验）。在BuCyE方案中用PKD IV Bu替代后，我们观察到接受autoHSCT的中，高危侵袭性非霍奇金淋巴瘤患者的非复发死亡率较低，总体生存率和无进展生存率均提高。

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