自体造血干细胞移植治疗恶性血液病61例疗效分析  

Analysis of autologous hemopoietic stem cell transplantation for 61 patients with hematological malignancies

作　　者：彭捷[1] 徐雅靖[1] 傅敢[1] 刘弋[1] 陈焱[1] 祝焱[1] 何群[1] 刘巍[1] 吴登蜀[1] 赵谢兰[1] 钟美佐[1] 陈方平[1] 

机构地区：[1]中南大学湘雅医院血液科,长沙410008

出　　处：《白血病．淋巴瘤》2010年第12期728-731,共4页Journal of Leukemia & Lymphoma

摘　　要：目的 评价自体造血干细胞移植（AHSCT）治疗恶性血液病的疗效.方法 中南大学湘雅医院1994年4月至2008年8月对61例恶性血液病患者进行了61次AHSCT治疗,移植时急性非淋巴细胞白血病（ANLL）30例,非霍奇金淋巴瘤（NHL）25例,霍奇金淋巴瘤（HL）3例,浆细胞瘤3例.ANLL采用预处理为MAC方案：美法仑（Mel）160mg/m2×1次,阿糖胞苷（Ara-C）2.0 g或2.5 g×2次,环磷酰胺（Cy）1.8 g/m2×2次;淋巴瘤以及浆细胞瘤采用预处理方案：全身照射（TBI）＋Cy,单次照射8～10 Gy,剂量率5 cGy/min,Cy 1.8 g/m2×2次.或在以上方案基础上进行修改.结果 所有患者造血重建,1例患者移植过程中心脏衰竭死亡,移植相关死亡率为1.6%.60例患者长期随访,1例失访.移植组中位随访期为52（2～211）个月,复发13例（21.3%）,复发中位时间为18（2～77）个月.死亡14例（23.0%）,现生存47例（77.0%）,中位生存时间为66（15～211）个月.5年无病生存（DFS）率为（77.5±5.5）%,比同期单纯接受化疗者的（31.6±7.3）%明显增高,差异有统计学意义（P＜0.01）.结论 AHSCT移植患者移植相关死亡率低,无病生存率较高,可作为恶性血液病治疗的重要方法.Objective To evaluate the clinical outcome of autologous hemopoietic stem cell transplantation （AHSCT） for hematological malignancies. Methods Data of 61 patients with hematological malignancies who underwent AHSCT in Xiangya Hospital from April 1994 to August 2008 were retrospectively analyzed. There were 30 acute non-lymphoblastic leukemias （ANLL）, 25 non-Hodgkin lymphoma （NHL）, 3 Hodgkin lymphoma （HL）, and 3 plasmacytoma. Mel 160 mg/m2 ＋ Ara-C 2.0/2.5 g × 2 ＋Cy 1.8 g/m2 × 2, or TBI 8-10 Gy ＋ Cy 1.8 g/m2 × 2 were mainly included in pretreatment regimens. Results All patients had rapid hemopoietic reconstitution. There was one patient who died of heart failure during the transplantation process. The rate of AHSCT related death was 1.6 %. The median follow up duration was 52（2-211） months. Forty-seven of 61 patients were still alive during the analysis. The probabilities of disease free survival （DFS） at 5 years were significantly different between these two groups： （77.5±5.5） % for AHSCT groups and （31.6±7.3） % for synchronous intensive chemotherapy groups（P 〈0.01）. Conclusion AHSCT can be safely performed as an important treatment constituent for hematological malignancies.

关 键 词：造血干细胞移植 血液肿瘤 并发症 无病生存率 

分 类 号：R733[医药卫生—肿瘤]