自体与异基因造血干细胞移植治疗侵袭性非霍奇金氏淋巴瘤疗效比较  

Effect Comparison Between Autologous and Allogeneic Hematopoietic Stem Cell Transplantation for Patients of Aggressive Non-Hodgkin′s Lymphoma

作　　者：邹外一[1] 童秀珍[1] 许多荣[1] 李娟[1] 罗绍凯[1] 彭爱华[1] 张国材[1] 郑冬[1] 

机构地区：[1]中山大学附属第一医院血液科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2008年第5期620-623,共4页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技计划基金(2006B36005010)

摘　　要：【目的】回顾性分析自体与异基因造血干细胞移植治疗侵袭性非霍奇金氏淋巴瘤(NHL)的疗效及预后因素。【方法】36例患者均为1993年6月至2005年9月住院接受移植的侵袭性NHL患者,其中自体造血干细胞移植(Auto-HSCT)23例,异基因造血干细胞移植(Allo-HSCT)13例,预处理方案全身照射+环磷酰胺(TBI/CY)18例,白消安+环磷酰胺(BU/CY)18例。随访时间为30个月-147个月,中位时间108个月。【结果】造血重建100%,侵袭性NHL患者Allo-HSCT后5年总生存率(OS)高于Auto-HSCT(53.83%±6.06% vs 30.46%±5.42%,P=0.001),Auto-HSCT5年复发率较高(60.82%±7.42%vs23.16%±3.03%,P=0.001),移植相关死亡率则Allo-HSCT较高(34.33%±4.21% vs 13.43%±1.78%,P=0.011),多因素分析:移植前完全缓解(CR)患者疗效高于原发耐药者,Allo-HSCT5年OS高于Auto-HSCT,而预处理方案、干细胞来源、侵袭性病理类型两者生存率无差别。【结论】Allo-HSCT是治疗侵袭性NHL的有效方法,其远期复发率低,但是如何减少移植相关死亡率是目前需迫切解决的关键因素之一。[Objective] Retrospective study of the patients with aggressive non-Hodgkin＇s lymphoma treated with autologous hematopoietic stem cell transplantation （auto-HSCT） or allogeneic hematopoietic stem cell transplantation （allo-HSCT） for treatment effect and prognosed factors. [Methods] Thirty-six cases of aggressive non-Hodgkin＇s lymphoma, among them, 23 patients received auto-HSCT, and the other 13 patients received allo-HSCT. Eighteen cases of patients received TBI/CY（total body irradiation with cyclophosphamide） as conditioning regimen and the other 18 cases received BU/CY （Busulfan/cyclogphosphamide）. The followup period was between 30 months and 147 months （median time was 108 months）. [Results] All patients gained complete hematopoietc reconstitution. The 5-year overall survival （OS）rate of allo-HSCT was higher than that of auto-HSCT （53.83% ± 6.06% vs 30.46% ± 5.42%,P = 0.001）, the relapse rate of auto-HSCT was higher than that of allo-HSCT （60.82% ± 7.42% vs 23.16% ± 3.03%,P = 0.001）. Transplantation-assosiated death was more with allo-HSCT comparing with auto-HSCT （34.33%±4.21% Vs 13.43%±1.78%,P = 0.011）. Multi-factor analysis showed that patients who reached complete remission before the transplantation got a better result than patients with primary drug-resistant, the 5-year OS of allo-HSCT was higher than auto-HSCT. Conditioning regimen, source of stem cell and pathologic types of the lymphoma showed no significant difference on survival. [Conclusions] allo-HSCT is effective way in the treatment of aggressive non-Hogdkin＇s lymphoma, with a low long-term relapse rate. But to reduce the transplantation-assosiated death is a current emergence.

关 键 词：造血干细胞移植 非霍奇金氏淋巴瘤 侵袭性 

分 类 号：R733.71[医药卫生—肿瘤]