交替半身照射治疗恶性血液病的初步临床研究  

Preliminary study on alternative half body irradiation in th treatment of hematological malignancies

作　　者：魏嘉璘[1] 王玫[1] 邹德慧[1] 杨栋林[1] 李睿[1] 宁军[1] 冯四洲[1] 韩明哲[1] 

机构地区：[1]中国医学科学院,中国协和医科大学血液学研究所,血液病医院,天津300020

出　　处：《中华血液学杂志》2004年第6期355-358,共4页Chinese Journal of Hematology

摘　　要：目的　评价交替半身照射 (AHBI)治疗恶性血液病的疗效。方法　采用AHBI治疗 17例恶性血液病患者。先给予大剂量化疗 ,然后分别对上、下半身照射 6～ 9Gy。上半身照射在停用大剂量化疗中位时间 14 (12～ 2 2 )d进行 ,上、下半身照射中位间隔时间为 2 3(7～ 34)d。同时选择同期行自体造血干细胞移植 (AHSCT)的 14例急性淋巴细胞白血病 (ALL)患者作为对照组。结果　 17例AHBI治疗的患者均获得造血恢复。完全缓解期进行AHBI治疗患者的 3年无病生存 (DFS)率为(5 2 .38± 13.4 7) % ,最长生存期为 14 4 6d ,中位随访时间为 92 7(4 2 8～ 14 4 6 )d ,无一例发生治疗相关死亡。其中 11例ALL患者 3年DFS率为 (4 7.73± 17.5 5 ) % ;AHSCT组 3年DFS率为 (5 3.88±14 .0 8) % ,移植相关死亡率为 14 %。两组ALL患者的 3年DFS率相比无显著性差异 (P >0 .0 5 )。结论　AHBI可作为恶性血液病的一种治疗手段。Objective To evaluate the curative effect of alternative half body irradiation(AHBI) in the treatment of hematological malignancies. Methods Seventeen patients with hematological malignancies in complete remisson received a high-dose chemotherapy, followed by a two-step AHBI on day 14 (12 ～ 22),upper (UHBI) and lower half body irradiation (LHBI) were sequentially given with each a single dose of 6 ～ 9 Gy at an interval of 23 (7 ～ 34) days. Fourteen received autologous hematopoietic stem cell transplantation (AHSCT) during the same period were chosen as control. Results Hematopoiesis recovery was observed in all the AHBI patients. The 3-year disease free survival (DFS) rate and the AHBI-related mortality were (52.38±13.47)% and 0, respectively. The longest survival time was 1446 days with a median follow-up period of 927(428～1446) days. The 3-year DFS for the 11 acute lymphocytic leukemia (ALL) patients was (47.73±17.55)%.By contrast, the 3-year DFS and the AHSCT-related mortality for the 14 ALL patients in the control AHSCT group were ( 53.88 ± 14.08 )% and 14%, respectively. There was no significant difference in 3-year DFS between AHBI and AHSCT ALL patients. Conclusions AHBI provides a feasible approach for hematological malignancy patients.

关 键 词：交替半身照射 恶性血液病 AHBI 干细胞移植 造血干细胞 

分 类 号：R733[医药卫生—肿瘤]