自体外周血造血干细胞移植治疗恶性淋巴瘤患者长期随访及疗效观察  

Clinical Observation and Long-time Follow-up of Patients with Malignant Lymphoma treated with Autologous Peripheral Blood Hematopoietic Stem Cell Transplantation

作　　者：胡凯[1] 王继军[1] 赵伟[1] 田磊[1] 万伟[1] 克晓燕[1] 

机构地区：[1]北京大学第三医院血液科,北京100191

出　　处：《中国实验血液学杂志》2013年第6期1471-1476,共6页Journal of Experimental Hematology

基　　金：卫生行业科研专项项目(编号:201002009);首都医学发展科研基金(编号:2009-1013)

摘　　要：本研究探讨自体外周血干细胞移植治疗恶性淋巴瘤疾病的疗效。回顾性分析并随访自1992年1月至2012年6月在我院运用自体外周血造血干细胞移植治疗72例恶性淋巴瘤患者,其中非霍奇金淋巴瘤56例,霍奇金淋巴瘤16例。预处理方案为:55例患者采用以全身放疗(TBI)联合环磷酰胺为基础,部分霍奇金淋巴瘤和非霍奇金淋巴瘤患者再联合应用足叶乙甙和/或表阿霉素;另外22例患者采用卡氮芥、足叶乙甙、阿糖胞苷、马法兰(BEAM)联合化疗方案。回输CD34+细胞均值为(6.6±4.9)×106/kg。结果表明:所有患者均成功重建造血,移植后外周血中性粒细胞恢复(ANC≥0.5×109/L)平均时间为12±4.4 d,血小板恢复(Plt≥20×109/L)平均时间为14±4.9 d,移植相关死亡率为4.2%。移植后随访6-217个月,中位随访时间为63.5个月。1年、3年、5年、10年总生存率分别为(92.3±3.2)%;(81.4±4.9)%;(77.6±5.3)%;(68.9±6.8)%。结论:自体外周血造血干细胞移植治疗恶性淋巴瘤疗效较好,长期随访患者生存率较高,且安全性良好。移植前治疗达到完全缓解(CR)的患者疗效显著优于未达CR患者。This study was purposed to evaluate the efficacy of autologous peripheral blood hematopoietic stem cell transplantation （auto-PBHSCT） for patients with malignant lymphoma. From January 1992 to June 2012, 32 malignant lymphoma （ML） patients were treated with auto-PBHSCT in our hospital. There were 56 cases of non-Hodgkins lymphoma（NHL） and 16 cases of Hodgkin＇s lymphoma （HD）. The preconditionging regimens of total body irradiation （TBI） plus cyclophosphamide combined with etoposide/pharmorubicin were used in 50 patients, and the BEAM （ BCNU ＋ etoposide ＋ Ara-C ＋ melphalan） were used in the other 22 patients. The average number of CD34＋ cells was （6. 6± 4. 9） × 10^6/kg. The results showed that transplanted cells were engrafted and hematopoiesis was reconstituted in all patients. The median time of neutropilic granulocyte recovery up to≥0. 5 × 10^9/L was 12 ±4. 4 days, and the platelet recovery up to 920 × 10^9/L was 14 ± 4. 9 days . The transplantation related mortality was 4. 2%. The patients were followed up for 6 -217 months. The median follow-up time was 63.5 months. 1-year OS rate was 92. 3 ± 3.2%. 3- years OS rate was 81.4 ±4. 9%. 5-years OS rate was 77. 6±5.3%. 10-years OS rate was 68.9 ±6. 8%. It is concluded that auto-PBHSCT is effective for malignant lymphoma, and long time follow-up shows that the OS rate is still high. Furthermore, the safety of auto-PBHSCT can also be received. Before transplantation the patients with CR can get higher OS rate.

关 键 词：恶性淋巴瘤 预处理方案 自体外周血干细胞移植 

分 类 号：R733.1[医药卫生—肿瘤] R457.7[医药卫生—临床医学]