Current treatment strategies in northern Europe of non-Hodgkin lymphoma are presented. High-grade malignant lymphomas have been treated with doxorubicin-containing polychemotherapy in various modes. The advantage of six-drug regimens over CHOP-like therapy is as yet not proven. Patients with the ability to tolerate the calculated dose have good prognosis. High-dose therapy and bone marrow transplantation should be considered in poor-risk patients with lymphoblastic lymphomas in first remission, patients with all high-grade histologies in partial remission after first-line therapy and patients with relapse that are still responsive to therapy. Preliminary results from autologous bone marrow transplantation in follicular lymphoma are also encouraging. Chlorambucil induces multiple remissions in follicular lymphoma, with a median duration of the 1st, 2nd and 3rd remission being the same. The watch and wait strategy seems justified initially in most asymptomatic generalized low-grade malignant lymphomas. Systemic therapy is required in aggressive stage II-IV lymphomas. A meticulous investigation is needed for stage I patients before giving local treatment only. Immune phenotyping is of great value for diagnosis and staging. Liver, but not bone marrow involvement seems to be an adverse prognostic factor. Follicular lymphoma is an example of a dynamic tumour with gradual cellular changes associated with new and more malignant clinical signs.

译文

:介绍了北欧非霍奇金淋巴瘤的当前治疗策略。高度恶性淋巴瘤已用含阿霉素的多化学疗法以多种方式进行了治疗。与CHOP样疗法相比,六药疗法的优势尚未得到证实。有能力耐受计算剂量的患者预后良好。对于初次缓解的淋巴母细胞淋巴瘤的低危患者,一线治疗后部分缓解的所有高级别组织学患者以及仍对治疗有反应的复发患者,应考虑大剂量治疗和骨髓移植。自体骨髓移植治疗滤泡性淋巴瘤的初步结果也令人鼓舞。苯丁酸氮芥在滤泡性淋巴瘤中引起多种缓解,第一,第二和第三缓解的中位持续时间相同。在大多数无症状的广义低度恶性淋巴瘤中,最初的观察和等待策略似乎是合理的。侵袭性II-IV期淋巴瘤需要全身治疗。 I期患者需要进行细致的调查,然后才进行局部治疗。免疫表型对于诊断和分期具有重要价值。肝而不是骨髓受累似乎是不良的预后因素。滤泡性淋巴瘤是动态肿瘤的一个例子,随着新的和更恶性的临床体征而逐渐发生细胞变化。

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