异基因造血干细胞移植术治疗自体造血干细胞移植术后复发的恶性淋巴瘤17例效果分析  

Allogeneic hematopoietic stem cell transplantation for recurrent lymphoma after autologous stem cell transplantation:clinical analysis of 17 cases

作　　者：苏毅[1] 赖思含[1] 易海[1] 付利[1] 范方毅[1] 孙浩平[1] 刘阳阳[1] 邓涛[1] 王译[1] 何光翠[1] 

机构地区：[1]成都军区总医院血液科,成都610083

出　　处：《第三军医大学学报》2012年第24期2456-2458,共3页Journal of Third Military Medical University

摘　　要：目的观察异基因造血干细胞移植治疗自体造血干细胞移植后复发的恶性淋巴瘤的临床效果。方法本科2000-2011年采用异基因亲缘造血干细胞移植术治疗自体造血干细胞移植术后复发的恶性淋巴瘤患者17例,HLA配型全相合(6/6相合)10例,5/6相合5例,4/6相合2例。预处理方案采用环磷酰胺120 mg/kg分2 d静滴,马利兰12～14 mg/kg分4 d口服,氟达拉滨30 mg/m2×5 d。全相合供体采用CsA+MTX+MMF预防移植物抗宿主病(graft-versus-host disease,GVHD),不全相合供体采用ATG+CsA+MTX+MMF预防GVHD。移植物均为外周血造血干细胞加骨髓。结果 17例患者均获造血重建,发生急性GVHD 9例(52.94%),发生慢性GVHD 11例(64.71%)。随访12～120个月,6例患者分别于移植后8、11、15、19、21、34个月疾病复发而死亡,3例患者死于GVHD合并感染,余8例健康存活。结论异基因造血干细胞移植是治疗自体造血干细胞移植后复发的恶性淋巴瘤患者的有效方法。Objective To observe the clinical efficacy of allogeneic hematopoietic stem cell transplantation （allo-HSCT） on recurrent lymphoma after autologous stem cell transplantation （auto-HSCT）. Methods A total of 17 patients with recurrent lymphoma after auto-HSCT underwent allo-HSCT in our department from January 2000 to December 2011. There were human leukocyte antigen （HLA） full matched （6/6） in 10 patients, 5/6 matched in 5, and 4/6 matched in 2. All patents were treated with standardized conditioning regimen consisting of cyclophosphamide 120 mg/kg in 2 d, busulfan 12 to 14 mg/kg in 4 d by oral taking, and fludarabine 30 mg/m2 for 1 to 5 d. Graft-versus-host disease （GVHD） was prevented by CsA ＋ MTX ＋ MMF for HLA full-matched and ATG ＋ CsA ＋ MTX ＋ MMF for mismatched. Grafts were peripheral blood stem ceils and bone marrow. Results Hematopoietic reconstitution achieved in all 17 patients. There were 9 cases （52.94%） with acute GVHD, and 11 cases （64.70%） with chronic GVHD. During the follow-up period of 12 to 120 month, 6 patients died of disease recurrence after transplantation 8, 11, 15, 19, 21, and 34 months respectively, 3 died of GVHD with infection, and 8 survived until now. Conclusion Allo-HSCT is an effective therapy for recurrent lymphoma after auto-HSCT.

关 键 词：异基因造血干细胞移植 自体造血干细胞移植 复发 淋巴瘤 

分 类 号：R617[医药卫生—外科学] R730.6[医药卫生—临床医学]