악성 림프종 환자에서 BEAM 고용량화학요법과 자가조혈모세포이식

• Published in: The Korean journal of medicine Vol. 61; no. 3; pp. 255 - 263
• Main Authors: 박진노, Jin No Park, 홍영선, Young Seon Hong, 송치원, Chee Won Song, 조석구, Seok Goo Cho, 이종욱, Jong Wook Lee, 민우성, Woo Sung Min, 김춘추, Chun Choo Kim, 이경식, Kyung Shick Lee
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 01.09.2001
• Subjects: Autologous stem cell transplantation; BEAM; Lymphoma
• ISSN: 1738-9364

Background : The long-term survival in patients with non-Hodgkin's lymphoma (NHL) after conventional chemotherapy is about 35% and the rest of the patients tend to have relapse. So, in relapsed or refractory NHL, the outcome of patients undergoing high-dose chemotherapy and autologous peripheral stem cell transplantation (APBSCT) was evaluated, and the main prognostic factors were determined. Methods : 17 patients with relapsed or resistant NHL (5 complete response group, 7 partial response group, 4 primary refractory group, 1 resistant relapse) underwent BEAM (carmustine, etoposide, cytarabine, melphalan) chemotherapy and APBSCT between July 1997 and February 1999. Results : The median follow-up duration was 17 months (range: 4-47). The response rate was 58.3% (complete response 33.3%, partial response 25.0%) in 12 patients in whom complete response group was not included. The 2-year, 3-year overall response rate were 41.2%, 27.5%, respectively. And 2-year progression free survival was 35.3%. The disease status before high-dose chemotherapy was the only significant prognostic factor in determining overall survival (univariate p=.024, multivariate p=.059) and progression free survival (univariate p=.013, multivariate p=.026). Patients with complete response to salvage regimen had better overall survival (p=.021) and progression free survival (p=.008) than patients with refractory response. WBC (≥ 1,000/uL) was recovered at the median 11 days (range; 8-24), and platelet (≥ 50,000/uL) was recovered at the median 18 days (range; 9-44). There was no treatment-related death and no grade 3 and 4 toxicity. Neutropenic infection was in 4 patients (1 Herpes zoster, 1 typhlitis, 1 perianal infection, 1 otitis externa). Conclusion : The pre-transplant disease status was the main prognostic factor. Patients with complete response to salvage regimen had the significant benefit in survival from high-dose chemotherapy and APBSCT, but patients with refractory or resistant relapsed NHL did not have any significant benefit.(Korean J Med 61:255-263, 2001)