造血细胞移植治疗滤泡性非霍奇金淋巴瘤的争议与最新进展。

Bone Marrow Research Pub Date : 2012-01-01 Epub Date: 2012-10-11 DOI:10.1155/2012/897215
Abraham S Kanate, Mohamed A Kharfan-Dabaja, Mehdi Hamadani
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引用次数: 1

摘要

滤泡性淋巴瘤(FL)通常被认为是一种惰性非霍奇金淋巴瘤,具有显著的病理生物学和临床异质性。FL的初始治疗策略已经演变为包括联合化疗免疫治疗和/或放射免疫偶联物。不幸的是,即使采用目前最好的非移植治疗方法(这种方法的疗效更高),FL仍然无法治愈。虽然被认为是一种可行的治疗选择,但使用造血细胞移植(HCT)仍然存在争议。在FL中,适当的时间、移植物来源和HCT调理方案的强度经常是争论的问题。在本文中,我们回顾了有关在不同阶段的FL患者中使用自体或同种异体HCT的现有已发表数据,讨论了该领域的最新进展,并强调了未来研究的途径。目前的文献不支持HCT在首次缓解中对FL的作用,但在复发的情况下,自体HCT仍然适用于早期化疗敏感复发的患者,而同种异体移植仍然是该疾病的唯一治疗方式,适用于相对年轻、无明显合共病的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Controversies and recent advances in hematopoietic cell transplantation for follicular non-hodgkin lymphoma.

Commonly designated as an indolent non-Hodgkin lymphoma, follicular lymphoma (FL) presents with striking pathobiological and clinical heterogeneity. Initial management strategies for FL have evolved to involve combination chemoimmunotherapy and/or radio-immunoconjugates. Unfortunately even with the best available nontransplant treatment, which nowadays results in higher frequency of response, FL remains incurable. Although considered a feasible therapeutic option, the use of hematopoietic cell transplantation (HCT) remains controversial. The appropriate timing, graft source, and intensity of HCT conditioning regimens in FL are often matters of debate. Herein we review the available published data pertaining to the use of autologous or allogeneic HCT in patients with FL across different stages of the disease, discuss major recent advances in the field, and highlight avenues for future research. The current literature does not support a role of HCT for FL in first remission, but in the relapsed setting autologous HCT remains appropriate for patients with early chemosensitive relapses, while allogeneic transplantation remains the sole curative modality for this disease, in relatively younger patients without significant comorbidities.

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