外周血干细胞移植治疗高危非霍奇金病3例  

Treatment with Peripheral Blood Hematopoietic Stem Cell Transplantation for Three Cases of High Risk Non-Hodgkin Lymphoma

作　　者：郭海霞[1] 檀卫平[1] 黄科[1] 严海燕[1] 方建培[1] 

机构地区：[1]中山大学附属第二医院儿科,广州510120

出　　处：《实用儿科临床杂志》2008年第3期182-184,共3页Journal of Applied Clinical Pediatrics

基　　金：广东科技计划项目资助(2006B36301003)

摘　　要：目的探讨外周血造血干细胞移植(PBSCT)治疗高危非霍奇金病患儿(NHL)的方法和疗效。方法对2例高危小无裂型NHL进行自体外周血干细胞移植(APBSCT),1例大细胞型淋巴瘤患儿进行血缘相关PBSCT。2例APBSCT采用环磷酰胺(CTX)3g/m2化疗联合粒细胞集落刺激因子(G-CSF)动员,后予小剂量全身照射(TBI)加抗CD20单抗及不同化疗预处理;1例血缘相关PBSCT患儿予小剂量TBI加化疗预处理,其后回输保存的外周血干细胞。结果3例患儿均移植成功。2例APBSCT移植后1个月复查深部淋巴结消失,随访至移植后22、27个月,造血功能恢复良好,病情处于持续完全缓解状态,仍在继续随访中;1例血缘相关PBSCT移植后5个月死于肺炎。结论PBSCT是治疗儿童高危NHL的有效方法之一,合适的移植时机和预处理至关重要。在早期化疗敏感时行APBSCT,可改善预后。降低放射量,联合强化疗及利妥昔单抗的预处理方案,亦达到预期移植效果。Objective To explore the treatment methods and effect of peripheral blood hematopoietic stem cell transplantation （PBSCT） for high- risk non - Hodgkin lymphoma（NHL） in children. Methods Two cases with Burkitt＇s lymphoma received auto -PBSCT（ APB- SCT） and 1 case with T cell anaplastic lymphoma received related PBSCT. Two APBSCT patients were mobilized with regimen of cyelophosphamide （3 g/m^2 ） combined with granulocyte colony - stimulating factor （ G - CSF ） and then received the conditioning regimen of low - dose total- body irradiation （TBI） , anti -CD20 -monoclonal antibody （rituximab）and different chemotherapy. The related PBSCT patient received the conditioning regimen of low - dose TBI and chemotherapy. Results The hematopoietic stem cell were all transplanted successfully. The deep lymphoid nodes disappeared in 1 month post - APBSCT. The 2 patients were followed for 22,27 months after APBSCT and the function of hemopoiesis was well. The state of illness retained continuous complete remission. The other patient died of pneumonia 5 months after related PBSCT. Conclusions The treatment of PBSCT is an effective way for high - risk NHL in children. Suitable time of transplantation and good conditioning regimen are very important. APBSCT can improve prognosis if being done in the early stage of being sensitive to chemotherapy. Preconditioning regimen including reduced radiation dose, strong chemotherapy and anti - CD20 - monoclonal antibody has expecting transplantation effect.

关 键 词：外周血干细胞移植 抗CD20 单克隆抗体 非霍奇金病 儿童 

分 类 号：R733.1[医药卫生—肿瘤]