自体外周血干细胞移植治疗恶性淋巴瘤  

Autologous hemotopoietic stem cell transplantation for treatment of patients with lymphoma

作　　者：杨顺娥[1] 徐继鸿[1] 穆尼拉[1] 贾存东[1] 徐怡[1] 朱娓[1] 

机构地区：[1]新疆医科大学附属肿瘤医院内一科,新疆乌鲁木齐830011

出　　处：《新疆医科大学学报》2004年第6期600-601,共2页Journal of Xinjiang Medical University

基　　金：乌鲁木齐市科委科技创新项目 (项目编号 :Y3 0 80 2 )

摘　　要：目的 :探讨高剂量化放疗联合自体外周血干细胞移植 (APBSCT)治疗恶性淋巴瘤的疗效和安全性。 方法 :接受高剂量化放疗联合APBSCT治疗的 5例恶性淋巴瘤 ,其中非霍奇金淋巴瘤 (NHL) 4例 ,霍奇金淋巴瘤(HL) 1例。外周血干细胞的动员方法 :1例采用Ara C 10 g/m2 静点 +G CSF ,余 4例采用VP 16 15 0 0mg/m2 静点 +G CSF。干细胞动员后 ,采集单个核细胞数 (MNC)均≥ 3.85× 10 8/kg ;CD3 4 + 细胞数均≥ 6 .96× 10 6/kg ,CFU GM培养集落数≥ 4 .4 1× 10 5/kg。预处理方案 :1例NHL为CTX 4 g/m2 ,分 2次静点 ,VP 16 80 0mg/m2 ,分 4次静点 ,并加全身照射 (TBI) 780cGY。余 4例为CTX 4 g/m2 ,VP 16 80 0mg/m2 静点 ,BCNU 4 5 0mg/m2 静推 ,移植后进行了原发病灶的放疗。随访 9～ 4 3个月 ,中位 18个月。 5例移植前浅表淋巴结、纵隔、脾脏部位病变均获得部分缓解。 结果 :5例患者移植后均获得造血重建。移植后病变获得完全缓解 ,随访至 2 0 0 4年 5月 ,均无病存活。结论 :APBSCT联合大剂量化放疗 ,对恶性淋巴瘤疗效佳 ,且毒副反应能耐受 ,安全性好 ,值得进一步临床应用。Objective: To investigate the efficacy and safety of hig h dose chemoradiotherapy with autologous hemotopoietic stem cell transplantation (APBSCT) in curing lymphoma. Methods: 5 malignant lymphoma patients were treated with high dose chemoradiotherapy with APBSCT, there were 4 non-hodgkin's lymphoma and one Hodgkin's lymphoma. The mobilization plan of autologous peripheral blood stem cell:one was Ara-c 10 g/m\+2+G-CSF. 4 non-hodgkin's lymphoma were VP-16 1 500 mg/m\+2+G-CSF. After mobilization, collected MNC≥3.85×10\+8/kg, CD 34\++ cells≥6.96×10\+5/kg, and CFU-GM≥4.41×10\+5/kg. Primary treatment: 1 NHL was CTX 4 g/m\+2+VP-16 800 mg/m\+2+total body irradiation 780 cGy. Others were CTX 4 g/m\+2, VP-16 800 mg/m\+2, BCNU 450 mg/m\+2, and complementary irradiation in the primary sites after transplant, Follow 9-43 months,median follow-up of 18 months. Results: All patients obtained sustained hemolopoietic reconstitution. The disease received CR after transplantation. Up to 10 th May 2004, All cases were event-free survival. Conclusions: High dose chemoradiotherapy supported by APBSCT in the treatment of lymphoma is a safe and effective modality, however further clinic investigation is warranted.

关 键 词：自体外周血干细胞移植 恶性淋巴瘤 大剂量放化疗 

分 类 号：R457[医药卫生—治疗学] R733.4[医药卫生—临床医学]