MAG动员/BEAM预处理治疗恶性淋巴瘤的长期随访  

A long-term follow-up analysis of malignant lymphoma treated with MAG/BEAM protocole

作　　者：刘跃均[1] 吴德沛[1] 孙爱宁[1] 仇惠英[1] 金正明[1] 苗瞄[1] 唐晓文[1] 傅 马骁[1] 赵晔[1] 夏学鸣[1] 林宝爵[1] 

机构地区：[1]苏州大学附属第一医院江苏省血液研究所,215006

出　　处：《江苏医药》2005年第4期244-246,共3页Jiangsu Medical Journal

基　　金：江苏省卫生厅科研基金(H9816);江苏省135工程重点人才培养基金(RC2002033)

摘　　要：目的探讨恶性淋巴瘤(ML)用MAG方案动员、BEAM方案预处理、自体外周血干细胞移植(APBSCT)的疗效和毒性.方法 8年采用APBSCT治疗ML14例[9例非霍奇金淋巴瘤(NHL),5例霍奇金病(HD)],外周血干细胞动员采用MAG方案(Ara-C 2g/m2 q12 h,d1～2,MTZ 10 mg·m2d2～3,rhG-CSF 300 μg/d),为预处理采用BEAM方案(BCNU 250 mg/m2d1,VP-16 200 mg2d2～5,Ara-C 400 mg/m-2d2～5,Mel 140 mg/m2d6).化疗结束后36～48 h回输自体造血干细胞.结果 13/14例一次采集即获足量干/祖细胞.回输单个核细胞(MNC)3.91(1.21～6.61)×108/kg、粒-单核系祖细胞(CFU-GM) 4.40(2.33～6.47)×105/kg和CD34+细胞17.79(4.79～30.69)×106/kg.所有患者移植后均获造血重建,中性粒细胞(ANC)≥0.5×109/L时间为10(8～13) d,血小板(Plt)≥20×109/L为13(9～22) d.中位随访时间46(4～100)个月,12例存活,总生存率85.7%,无病生存率78.5%.结论 MAG方案动员/BEAM方案预处理APBSCT治疗ML安全有效.Objective To analyze the efficiacy and toxicity of malignant lymphoma(ML)treated with MAG/BEAM protocole and autologous peripheral blood stem cell transplantation (APBSCT).Methods 14 ML patients were treated with APBSCT in 8 years,9 non-Hodgkins lymphoma(NHL) and 5 Hodgkins lymphoma(HD).The mobilization regimen of peripheral blood stem cell was mitoxantrone(10mg/m2,d2 and d3)and high-dose cytarabine(2g/m2 every 12h,d1 and d2)followed by recombinant human granulocyte colony-stimulating factor 300μg/d(rhG-CSF 300μg/d).These patients were treated with BEAM regimen (BCNU 250mg/m2d1,VP-16200mg/m2d2～5,Ara-C 400mg/m2 d2～5,Mel 140mg/m2d6).Autologous hemotopoietic stem cells were reinfused 36～48 hours after completion of high dose chemotherapy.Results 13 patients got enough stem cell through one collection.MNC 3.91(1.21～6.61)×108/kg,CFU-GM4.40(2.33～6.47)×105/kg and CD34+ cells 17.79(4.79～30.69)×106/kg were reinfused in the patients of APBSCT.All patients obtained hemotopoietic reconstitution ANC≥0.5×109/L and Plt≥20×109/L were at day 10(8～13)and day 13(9～22)respectively.Twelve patients were alive with median 46(4～100)months.The total survival rate was 85.7%.The disease free survival rate was 78.5%.Conclusion MAG/BEAM protocole and APBSCT are safe and efficacious in patients with malignant lymphoma.

关 键 词：恶性淋巴瘤 BEAM MAG 长期随访 处理治疗 自体外周血干细胞移植 外周血干细胞动员 CD34^+细胞 非霍奇金淋巴瘤 自体造血干细胞 方案预处理 CT治疗 APBS 干/祖细胞 单个核细胞 中性粒细胞 无病生存率 霍奇金病 AM方案 造血重建 

分 类 号：R733.4[医药卫生—肿瘤] R651.15[医药卫生—临床医学]