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本文报道5例耐药且有骨髓浸润的NHL 病人以BEAM 方案化疗后用GM-CSF 治疗的情况。5例对化疗耐药的Ⅳ期NHL 病人,NWF 组织学分类低度恶性1例,中度3例,高度1例。例1有多组淋巴结累及,例2有Burkitt’s 淋巴瘤,肝脾肿大,例3有膈上淋巴结肿大和胃浸润;例2、3有CNS浸润,例4有巨大(>10cm)的胂块压迫输尿管,例5肝脾肿大,下腔静脉受压;所有病有均有骨髓受累,均无亲属适于用基因骨髓移植(BMT)。病人先行BEAM 化疗6天(卡氮介:300mg/M~2,VP-16:1200mg/M~2,Ara-C:800mg/M~2,马法兰:140mg/M~2)。化疗结束后24小时经中心静脉导管持续输注重组GM-CSF(250μg/m~2/d),直到WBC 达1×10~(?)/L 后再继续输注6天,病人在层流病房护理。
This article reports the 5 cases of resistant and bone marrow infiltration of NHL patients treated with BEAM regimen with GM-CSF treatment. Among the 5 patients with stage IV NHL who were resistant to chemotherapeutic drugs, NWF histologically classified as low grade 1, moderate 3, and high 1. Example 1 has multiple sets of lymph node involvement, case 2 has Burkitt’s lymphoma, hepatosplenomegaly, case 3 had supraclavicular lymph node enlargement and stomach infiltration; cases 2, 3 have CNS infiltration, Example 4 has a huge (> 10cm) Ureteral oppression, 5 cases of hepatosplenomegaly, inferior vena cava compression; all have bone marrow involvement, no relatives suitable for gene marrow transplantation (BMT). Patients were treated with BEAM for 6 days (300 mg / m 2, VP-16: 1200 mg / m 2, Ara-C: 800 mg / m 2, melphalan: 140 mg / m 2) 24 hours after chemotherapy, continuous infusion of recombinant GM-CSF (250μg / m 2 / d) through the central venous catheter until WBC up to 1 × 10 ~ (?) / L and then continue infusion for 6 days, the patient in the laminar flow Ward care.