晚期霍奇金淋巴瘤三种化疗方案对原始造血祖细胞的早期和中期毒性

Paolo G. Gobbi , Vittorio Rosti , Francesco Valentino , Elisa Bonetti , Francesco Merli , Caterina Stelitano , Alessandra Dondi , Giovanni Quarta , Simona Falorio , Massimo Federico
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引用次数: 6

摘要

早期干细胞储存库可通过几个周期的化疗而受损,并且这种损害可能在周围细胞减少正常化后持续存在。我们直接评估了3种目前用于晚期霍奇金淋巴瘤的化疗方案对骨髓祖细胞的损伤。病人和MethodsBone骨髓样本37名患者随机治疗根据ABVD(阿霉素/博来霉素/长春花碱/达卡巴嗪),COPPEBVCAD(环磷酰胺、长春新碱、甲基苄肼/泼尼松/盐酸表柔比星/博来霉素长春花碱/环己亚硝脲/美法仑/长春地辛),或BEACOPP(博来霉素/依托泊苷、阿霉素、环磷酰胺、长春新碱、甲基苄肼、强的松)安排拍摄前几天开始化疗和30天,6个月后完成。样品冷冻保存,单次解冻,培养5周,检测长期培养起始细胞(LTC-IC)。结果从LTC-IC的检出数量及其相对变化来看,ABVD方案LTC-IC早期减少最少,晚期恢复最好。COPPEBVCAD在早期造成了最大的损害,但在6个月时几乎完全恢复。在6个月时,BEACOPP引起中度早期毒性。结论不同化疗方案对骨髓祖细胞的晚期毒性不同,在首次治疗失败的情况下,应根据预期的早期反应率和随后的抢救可能性仔细权衡。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Early- and Intermediate-Term Toxicity to Primitive Hematopoietic Progenitor Cells of Three Chemotherapy Regimens for Advanced Hodgkin Lymphoma

Background

The early stem cell reservoir can be impaired by a few cycles of chemotherapy, and this impairment might persist after normalization of peripheral cytopenias. We directly evaluated the damage caused to marrow progenitor cells by 3 currently used chemotherapy regimens for advanced Hodgkin lymphoma.

Patients and Methods

Bone marrow samples from 37 patients randomly treated according to either the ABVD (doxorubicin/bleomycin/vinblastine/dacarbazine), COPPEBVCAD (cyclophosphamide/vincristine/procarbazine/prednisone/epirubicin/bleomycin/vinblastine/lomustine/melphalan/vindesine), or BEACOPP (bleomycin/etoposide/doxorubicin/cyclophosphamide/vincristine/procarbazine/prednisone)schedule were taken a few days before the start of chemotherapy and 30 days and 6 months after its completion. Samples were cryopreserved, thawed in a single session, and cultured for 5 weeks to detect long-term culture-initiating cells (LTC-IC).

Results

On the basis of the numbers of LTC-IC detected and of their relative variations, the ABVD regimen was associated with the least early reduction and the best late recovery of LTC-IC. COPPEBVCAD produced the greatest early damage, but recovery was nearly complete by 6 months. BEACOPP caused intermediate early toxicity that persisted at 6 months.

Conclusion

The different late toxicity exerted on marrow progenitors by these chemotherapy regimens should be carefully weighed in relation to both the expected early response rate and subsequent possibility of rescue in the case of first treatment failure.

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