自体造血干细胞移植治疗首次CR非霍奇金淋巴瘤  

Non-Hodgkin's Lymphoma in First Complete Remission Were Treated by Autlogous Hemotopoietic Stem Cells Transplantation

作　　者：彭玉龙[1] 陈荣辉[1] 黄连涛[1] 秦巧玲[1] 吴远军[1] 王前[1] 高翔[1] 

机构地区：[1]中山大学附属东华医院肿瘤内科,广东东莞523110

出　　处：《中国医学工程》2010年第1期65-67,共3页China Medical Engineering

摘　　要：目的报告8例首次CR非霍奇金淋巴瘤(NHL)在外周血干细胞移植(PBSCT)支持下接受超大剂量化疗(HDC)的初步经验并评价所用外周血造血干细胞(PBSC)动员方案的动员效果,预处理方案的耐受性以及PBPC回输后造血重建情况。方法 8例NHL经常规化疗获首次完全缓解后,采用大剂量ICE方案(IFO5g/m2、卡铂AUC=7、VP-16500mg/m2)+G-CSF5μg/(kg.次)作动员方案,经超大剂量化疗方案BEAM(BCNU300mg/m2d1,VP-16200mg/m2d1-4,Ara-C200mg/m2q12hd1-4,Mephlan140mg/m2d4)进行预处理后回输PBSC。结果分别采集到MNC2.7(2.3-4.3)×108/kg,CFU-GM5.0(2.5-9.8)×105/kg和CD34+细胞2.9(2.1-8.8)×106/kg。回输PBSC后,均获快速重建造血功能,ANC>0.5×109/L和Pt>2.0×109/L的时间为10(8～12)d和11(9～18)d。非造血系统毒性较轻。随访至2009年6月底,中位随访时间24(10～46)个月,6例存活,1年生存率100%,3年存活率75%。结论自体外周血干细胞移植支持下超大剂量化疗是治疗首次CR非霍奇金淋巴瘤安全有效的临床手段,值得进一步研究。[Objective] The purpose of this study was to evaluate the efficacy of mobilization regimen,effectiveness and tolerance of BEAM in first complete remission patients with non-Hodgkin＇s lymphoma,and hemotopoietic reconstitution.[Methods] After confirmed complete remission from conventional chemotherapy,8 patients with primary NHL,were enrolled into this study and treated with BEAM（（BCNU 300 mg/m2 d1,VP-16 200 mg/m2 d1-4,Ara-C 200mg/m2 q12 h d1-4,Mephlan 140 mg/m2 d4））,patients were supported by APBSCT.Mobilization regimen for APBSCT was ICE（IFO 5 g/m2、Carboplatin AUC=7、VP-16 500 mg/m2）＋ G-CSF 5 μg/（kg ·次）.PBSC was re-infused 24~48 hours after completion of high dose chemotherapy.[Results] MNC2.7（2.3-4.3）×108 /kg,CFU-GM5.0（2.5-9.8）×105/kg and CD34 ＋ 2.9（2.1-8.8）×106/kg were re-infused in APBSCT respectively.All patients obtained prompt and sustained hemotopoietic reconstitution.ANC 0.5 ×109 /L and Pt 2.0×109 /L were at day 10（range,8～12）和day 11（range,9～18）respectively.6 patients were alive with median 24（range,10~46）months follow-up till end of June 2009.The 1 and 3 years survival rate were 100% and 75%,respectively.Non-hemotologic toxicity was mild and tolerable.[Conclusions] High dose chemotherapy supported by AHSCT in the treatment of primary CR NHL is a safe and effective modality.However further investigation is warranted.

关 键 词：外周血干细胞移植 非霍奇金淋巴瘤 超大剂量化疗 

分 类 号：R733.1[医药卫生—肿瘤]