大剂量化疗并自体外周血干细胞移植治疗 9例实体瘤分析  

Treatment of 9 cases of solid tumor using high dose chemotherapy with peripheral blood progenitor cell support.

作　　者：程刚[1] 衣林[1] 伍建宇[1] 张永强[1] 周美珍[1] 

机构地区：[1]卫生部北京医院肿瘤内科,北京100730

出　　处：《癌症》1999年第6期691-693,701,共4页Chinese Journal of Cancer

摘　　要：目的 :探讨高剂量化疗并自体外周血干细胞移植治疗高危实体瘤的可行性及疗效并了解干细胞动员、采集时机、骨髓恢复时间等问题。方法 :9例经病理确诊的高危乳腺癌、淋巴瘤及小细胞肺癌在经不同程度的化疗后 ,进行了大剂量化疗并自体外周血干细胞的移植。结果 :经追踪 7个月 ,9例全部生存 ,7例无病生存。当回输的单个核细胞 (MNC)大于 1.5× 10 8/kg ,中性粒细胞恢复至大于或等于 0 .5× 10 9/L和血小板大于或等于 2 0× 10 9/L所需的天数分别为 9天和 9.4天 ,无 1例出现骨髓功能不全的表现。结论 :大剂量化疗并自体外周血干细胞移植对乳腺癌、淋巴瘤及小细胞肺癌这类肿瘤疗效好 ,且较安全 ,而骨髓恢复的快慢似和回输的单个核细胞的量有关 ,和年龄无关 ,但由于本文病例数较少 ,且追踪时间相对较短 。Objective:To study the possibility and efficacy of high dose chemotherapy with autologous peripheral blood progenitor cell transplantation in the treatment of high risk solid tumors, and to study the issues of stem cell mobilization,harvest timing and bone marrow engraftment. Methods :9 patients with pathologically confirmed high risk breast cancer, lymphoma,and small cell lung cancer,previously treated with chemotherapy were treated with this procedure. Results:All of the patients are alive and 7 are disease free at 7 month follow up. When the reinfused mono nuclear cells (MNC)were more than 1.5×10 8/kg,all patients engrafted with the mean number of days to a neutrophil counts ≥0.5×10 9/L being 9 days and that to a platelet counts ≥20×10 9/L being 9.4 days. No bone marrow dysfunction was observed after this procedure throughout the 7 months. Conclusions:Based on these experience,treatment of the high risk breast cancer,lymphoma,small cell lung cancer with high dose chemotherapy supported by autologous peripheral blood progenitor cell transplantation is both effective and safe. The time to bone marrow engraftment is related to the number of MNC,but not the patient's age. Further research needs to confirm the beneficial of this procedure since this study involved small number of patients with relatively short time followed up.

关 键 词：实体瘤 自体外周血 干细胞移植 药物疗法 

分 类 号：R730.53[医药卫生—肿瘤] R457[医药卫生—临床医学]