自体外周血干细胞移植、生物治疗、长间歇维持化疗序贯治疗恶性血液病的临床研究  

Clinical study on autologous peripheral blood stem cell transplantation used in the advanced age patients with malignant hemopathy

作　　者：张诚[1] 陈幸华[1] 张曦[1] 高蕾[1] 彭贤贵[1] 孔佩艳[1] 刘林[1] 刘红[1] 王武[1] 王庆余[1] 

机构地区：[1]第三军医大学新桥医院血液科,重庆400037

出　　处：《中国老年学杂志》2007年第20期1996-1998,共3页Chinese Journal of Gerontology

基　　金：重庆市医学重点学科建设基金(No2006C028);第三军医大学附属新桥医院"1520人才工程"专项基金

摘　　要：目的评价自体外周血干细胞移植治疗高龄恶性血液病的疗效。方法将60例老年患者分为移植组与非移植组，其中移植组的34例高龄恶性血液病患者首次缓解并经3—4个周期强化治疗后，行自体外周血干细胞移植，预处理方案采用MAC、M及CY＋TB1，造血重建后予以大剂量IL-2行生物治疗4个疗程，之后每3～4个月予以长间歇维持化疗1次，常用方案包括TA、MA、MP、CTOD等；非移植组的26例患者采用常规的化疗治疗。结果34例患者移植后均成功重建造血，无一例移植相关死亡。移植后维持化疗满2年的患者有20例，有10例复发（50％），其中6例死亡。34例患者中16例复发（47．1％），其中死亡8例。3年无病生存率为（43．0±7．1）％。26例常规化疗的患者中20例复发（76．9％），其中有12例死亡，3年无病生存率为（19．2±6．2）％。结论自体外周血干细胞移植、生物治疗、长间歇维持化疗序贯治疗高龄恶性血液病，治疗相关死亡率低，无病生存率较高，可作为改善高龄恶性血液病治疗效果的重要措施。Objective To evaluate the clinical eflqcacy of autologous peripheral blood stem cell transplantation （auto-PBSCT） in advanced patients with malignant hemopathy. Methods Sixty patients were divided into transplantation and non-transplantation groups. The thirty-four advanced patients with malignant hemopathy as transplantation group received auto-PBSCT after first remission induction and three/four courses intensification treatment. After auto-PBSCT, patients received high dose of IL-2 treatment for 28 days and long-interval maintenance therapy per 3 - 4 months. TA, MA, MP and CTOD were the frequently used treatment prescription. For non-transplantation group the twenty-six patients received the conventional chemotherapy. Results Thirty-four patients had rapid hematopoietic reconstitution after auto-PBSCT. There was no hematopoietic stem cell transplantation （HSCT） related death. After two years of long-interval maintenance therapy, ten of twenty patients were relapse （50%）, including six died patients. Sixteen of thirty-four patients were relapse （47.1% ）, including eight died patients. The 3 year disease-free survival （DFS） was （43.0 ± 7.1 ） %. Twenty of twenty-six patients with conventional chemotherapy were relapse （76. 9% ）, including twelve died patients. The 3 year DFS was （ 19. 2 ± 6.2） %. Conclusions Auto-PBSCT combine with long-interval maintenance therapy could be used as an important treatment owing to its low HSCT related death and relatively long DFS.

关 键 词：自体外周血干细胞移植 患者 恶性血液病 生物治疗 化疗 

分 类 号：R552[医药卫生—血液循环系统疾病]