原著論文 笹崎美幸, 森 政樹, 上澤光世, 藤原慎一郎, 菊池裕二, 佐藤一也, 松山智洋, 大嶺 謙, 上田真寿, 鈴木隆浩, 尾崎勝俊, 永井 正, 室井一男, 小澤敬也 Ⅰ 要約 / Burkitt lymphoma/leukemia;bl c-myc Ig B Hyper-CVAD/HD-TX/ Ara-C+Rituximab c-myc Hyper-CVAD/HD-TX/ Ara-C+Rituximab Ⅱ はじめに BL starry sky Ⅲ 対象と方法 BL starry sky CD CDCDCDCDCDCD CDaSIgHLA-DR CDCD CDTdT c-myc Ig t;q;qt;p;qt ;q;q JALSGJapan Adult Leukemia Study GroupB-ALL TX mg/
m x:daycpa mg/m x:day-vcr.mg/ m x:daydxr mg/m x:daydex mg/ m x:day-ittx mg+dex mg/body TX mg/m x:daycpa mg/ m x:day-vcr.mg/m x:dayetp mg/m x:day-dex mg/m x:day- ITTX mg+dex mg/body Hyper-CVAD/HD-TX/Ara-C Rituximab 表 1 NO IH N IY YK KY IY SK I 患者背景 O OT Jun- Dec- ar- Nov- Dec- ar- Dec- ar- eb- ar- XX tqq XY ---- addp delptqq -- addp +mar +mar +mar +mar XY addq XX addptqq addqaddxq XY tqq XY tqq XY tqq XY dertt deldeltt XX tqq XX addq+ addq XX + addq dry tap. / / / / / / / 図 1 Hyper-CVAD/HD-TX/Ara-C 療法
NO Prephase CPA+PSL G-CS ST B Ⅳ 結果 c-myc q / CR CR 表 2 治療と転帰 TX+CPA+VCR+DXR+DEX+IT TX+CPA+VCR+ETP+DEX+IT TX+CPA+VCR+DXR+DEX+IT TX+CPA+VCR+ETP+DEX+IT TX+CPA+VCR+DXR+DEX+IT TX+CPA+VCR+ETP+DEX+IT R+Hyper-CVAD R+HD-TX/Ara-C Hyper-CVAD HD-TX/Ara-C R+Hyper-CVAD R+HD-TX/Ara-C R+Hyper-CVAD R+HD-TX/Ara-C R+Hyper-CVAD R+HD-TX/Ara-C R+Hyper-CVAD R+HD-TX/Ara-C 図 2 Kaplan-eier 生存曲線 100 90 80 70 60 50 40 30 20 10 0
Ⅴ 考察 BL c-myc Ig B L BL B C-YC/IG t; q;q t;q;q CDCD CDCDCDasIgHLA-DR CDCD CDCDa CDBCLCD Ki BL D Hyper-CVAD/HD-TX/Ara-C BL Hyper-CVAD B-ALL/Burkitt CR OS. OS Rituximab BL hyper-fractionated BL Rituximab Hyper-CVAD/HD-TX/Ara-C BL BL GVL BL
文献 agrath IT: African Burkitts lymphoma. History, biology, clinical features, and treatment. Am J Pediatr Hematol Oncol : -, Kristie A, Gerard L, John C: Adult Burkitt leukemia andlymphoma. Blood : -, - Thomas DA, aderl S, OBrien S, et al. Chemoimmunotherapy with hyper-cvad plus rituximab for the treatment of adult Burkitt and Burkitt-type lymphoma or acute lymphoblastic leukemia. Cancer -, Kluin P, Harris NL, Stein H, et al, : B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma. In: WHO classification of Tumours of Haematopoietic and Lymphoid Tissues, ed by Swerdow SH, Campo E, Harris NL, et al., IARC press, Lyon,, pp- Niitsu N, Okamoto, iura I, et al. Clinical features and prognosis of de novo diffuse large B-cell lymphoma with t;and q/c-yc translocations. Leukemia :, Thomas DA, Cortes J, OBrien S, et al.: Hyper-CVAD Program in Burkitts-Type Adult Acute Lymphoblastic Leukemia. J Clin Oncol : -, reidberg JW, Ciminello L, Kelly J, et al.: Outcom of patients>age with Burkitt lymphomabltreated with aggressive chemotherapeutic regimens:results from the international Burkitt lymphoma cooperative group abstr. Blood : #, Peniket AJ, Ruiz de Elvira C, Taghipour G, et al.: An EBT registry matched study of allogeneic stem cell transplants for lymphoma: allogeneic transplantation is associated with a lower relapse rate but a higher procedure-related mortality rate than autologous transplantation. Bone arrow Transplantation : -, Sweetenham JW, Pearce R, Taghipour G, etal.: Adult Burkitts and Burkitt-like non-hodgkins lymphoma--outcome for patients treated with high-dose therapy and autologous stemcell transplantation in first remission or at relapse: results from the European Group for Blood and arrow Transplantation. J Clin Oncol : -,
Jichi edical University Journal Improved outcome of Burkitt lymphoma/ leukemia treated with a new strategy iyuki Sasazaki, asaki ori, ituyo Uesawa, Shinitirou uziwara, Yuuzi Kikuti, Kazuya Satou, Tomohiro atuyama, Ken Oomine, asuzu Ueda, Takahiro Suzuki, Katutosi Ozaki, Tadashi Nagai, Kazuo uroi, Keiya Ozawa Abstract Burkitt lymphoma/leukemia BLwas formerly recognized as an aggressive malignant lymphoma with a poor prognosis. To confirm whether the prognosis of BL is improved by the Hyper-CVAD/HD-TX/ Ara-C regimen with or without rituximab group Bcompared with the classical treatment regimen for acute lymphoblastic leukemia or non-hodgkin lymphoma group A, the outcomes of patients treated in our hospital from to were analyzed. The results showed that both groups had achieved complete remission with each induction therapy; however, of patients in group B had longterm remission, while of patients in group A who received bone marrow transplantation relapsed. In conclusion, the new strategy with short-duration combination chemotherapy is safe and useful for BL. Division of Hematology, Jichi edical University Hospital