大剂量BEAC方案联合自体外周血干细胞移植治疗弥漫大B细胞淋巴瘤的临床分析  

High-dose chemotherapy with autologous stem cell transplantation as consolidation therapy for patients with poor-risk diffuse large B-cell lymphoma

作　　者：贾存东[1] 朱娓[1] 古力克孜.吾守尔 赵兵[1] 玛依努尔.马木提 胡欣[1] 杨顺娥[1] 白靖平[2] 

机构地区：[1]新疆医科大学附属肿瘤医院化疗科,乌鲁木齐830011 [2]新疆医科大学附属肿瘤医院骨肿瘤科,乌鲁木齐830011

出　　处：《新疆医科大学学报》2012年第12期1654-1658,共5页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区自然科学基金(2012211A045)

摘　　要：目的观察大剂量BEAC方案[卡莫司汀(BCNU)、依托泊甙(VP-16)、阿糖胞苷(Ara-C)、环磷酰胺(CTX)]联合自体干细胞移植(autologous stem cell transplantation,ASCT)治疗具有不良预后因素的弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)的疗效。方法选择2000年1月-2011年12月新疆医科大学附属肿瘤医院收治按年龄调整的国际预后指数(Age-adjusted international prognostic index,aaIPI)评分为1～3分、行大剂量BEAC联合ASCT治疗的DLBCL患者35例,常规化疗疗效达完全缓解或部分缓解后行自体外周血干细胞动员,动员方案为VP-16联合粒细胞集落刺激因子(Granulocyte colony-stimulating factor,G-CSF)。大剂量化疗(high-dose chemotherapy,HDC)方案采用BEAC(BCNU 450mg/m2,第1～2d静注;VP-16 800mg/m2,第1～3d分2次静注;Ara-C 1.5g/m2,第1d静注;CTX 3.6g/m2第1～2d静注)方案。采用Kaplan-Meier法进行生存分析。结果 35例患者均移植成功,重建造血功能。移植前13例CR,22例PR,移植后23例CR,12例PR,无移植相关死亡,中位随访时间为39个月(7～135个月),随访期间6例因病情进展死亡,5年生存率为80%。结论采用大剂量BEAC方案联合ASCT治疗具有不良预后因素的DLBCL取得了较好疗效,值得进一步研究。Objective To investigate the efficacy of high-dose chemotherapy（HDC） with autologous stem cell transplantation（ASCT） as first-line consolidation therapy for patients with poor-risk diffuse large B-cell lymphoma （DLBCL）. Methods Selected 35 patients from January 2000 December--2011 in Affiliated Tumor Hospital of Xinjiang Medical University with the age-adjusted International Prognostic Index （Age-adjusted international prognostic index, aalPI） score of 1 to 3 points, the line of high-dose BEAC joint ASCT treatment of DLBCL. Conventional chemotherapy achieved complete remission or partial remission underwent autologous peripheral blood stem cell mobilization, mobilization program for VP-16 joint granu-loeyte colony-stimulating factor （granulocyte ＂colony＂ -stimulating factoi＇, G-CSF）. High-dose chemotherapy （high-dose chemotherapy, HDC） program BEAC （BCNU 450 mg/m2 , intravenous injection of 1-2 d; VP-16 800 mg/m2, 1-3 d 2 intravenously was taken; Ara-C 1.5 g/m2, 1 d intravenously; CTX 3.6 g/m2 1 to 2 d intravenously） program. Kaplan-Meier survival analysis was performed. Results Thirty five patients were transplanted successfully rebuild hematopoietic function. 13 cases of complete remission （CR） before transplantation, 22 partial remission （PR）, 23 cases of CR after transplantation, 12 cases of PR, no transplant-related deaths, median follow-up time was 39 months （7 to 135 months）, the follow-up period of six cases of death due to disease progression, The 5-year survival rate was 80G. Conclusion HDC and ASCT as first-line consolidation therapy is effective for patients with poor-risk DLBCL.

关 键 词：大剂量化疗 自体干细胞移植 弥漫大B细胞淋巴瘤 生存 

分 类 号：R733.4[医药卫生—肿瘤]