불응성의 비호즈킨성 림프종 환자에서 시행한 동종 조혈모세포이식

초록

Background:Adult patients with advanced non-Hodgkin's lymphoma in whom conventional chemotherapy has failed are seldom cured. To overcome this problem, we tried high-dose chemotherapy with allogeneic hematopoietic stem cell transplantation (HSCT) for patients with refractory non-Hodgkin's lymphomas. Methods:From Jan. 1999 to Dec. 1999, 3 patients had received allogeneic HSCT. All patients had disease that had been refractory to primary and second-line chemotherapy. Two patients had received stem cells from HLA-identical siblings, and one case was HLA-identical unrelated HSCT. The conditioning regimen was BEAM combination chemotherapy and it was consisted of carmustine 300 mg/m² (day -6), etoposide 200 mg/m² (day -5 to -2), cytarabine 200 mg/m² (twice daily, day -5 to -2) and melphalan 140 mg/m² (day -1). Results:Amount of infused CD34^(+) cells was 1.2× 10^(6)/kg, 1.9× 10^(6)/kg and 7.8× 10^(6)/kg, respectively. Two patients had no response at all, and died early due to disease progression in spite of high-dose chemotheray followed by allogeneic HSCT. One patient showed partial response but recurred in 5 months after allogeneic HSCT. Conclusion:The result of BEAM chemotherapy followed by allogeneic HSCT was disappointing in our series. But considering the refractoriness to previous therapy in all three patients, tolerability of the toxicity, and small size number, accumulation of more experiences is warranted.

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