高剂量化放疗联合自体造血干细胞移植治疗霍奇金淋巴瘤11例报告  

High Dose Chemoradiotherapy with Autologous Hemotopoietic StemCell Transplantation for Treatment of Patients with AdvancedHodgkin's Lymphoma: A Report of 11 Cases

作　　者：周生余[1] 石远凯[1] 何小慧[1] 韩晓红[1] 刘鹏[1] 杨建良[1] 周爱萍[1] 冯奉仪[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤医院内科,北京100021

出　　处：《癌症》2002年第4期405-408,共4页Chinese Journal of Cancer

基　　金：国家"九五"攻关科题(96-960-01-12);霍英东高等院校优秀青年教师基金

摘　　要：背景与目的:高剂量化放疗(highdosechemoradiotherapy,HDT)联合自体造血干细胞移植(autologoushemotopoieticstemcell,ASCT)已成为复发与耐药霍奇金淋巴瘤(HL)患者重要的解救治疗手段之一,但对于初治晚期患者的作用还不明确。本论文的目的是进一步评价HDT联合ASCT在HL综合治疗中的地位,特别是探讨其对于初治晚期具有明显不良预后因素患者的作用。方法:11例复发和具有不良预后因素的晚期HL患者,其中初治9例,复发2例;自体骨髓移植(autologousbonemarrowtransplantation,ABMT)1例,自体外周血干细胞移植(autologousperipheralbloodstemcelltransplantation,APBSCT)10例。诱导治疗后4例完全缓解(CR),7例部分缓解(PR)。7例采用高剂量化疗联合全身照射(totalbodyirradiation,TBI)或全淋巴结照射(totallymphnodeirradiation,TLI)/次全淋巴结照射(subtatallymphnodeirradiation,STLI)作为预处理方案,4例采用单纯高剂量化疗作为预处理方案。5例患者于移植后进行了原发部位的补量放疗。结果:移植前达CR者为巩固治疗,达PR者移植后2例达CR,1例达PR,4例稳定(SD);SD者均为骨受侵。中位随访13(1-84)个月,所有患者全部生存。4例无病生存;4例骨受侵者疾病无进展生存;3例复发,其中1例经复发部位放疗后。Background &Objectives: High dose chemoradiotherapy (HDT) with autologous hemotopoietic stem cell transplantation (ASCT) has become one of the important salvaged treatments for the Hodgkins Lymphoma(HL) patients with relapsed or resistant disease, but its role as the primary treatment remains indefinite. This study was designed to further evaluate its status in the combined modality treatment, especially, to discuss its value in the primary treatment of the patients with advanced disease and poor prognosis. Methods: Eleven patients who had advanced or relapsed disease with poor prognosis were enrolled in this study. Among them, 9 patients were primary treatment, and 2 patients were secondary treatment. One patient received autologous bone marrow transplantation (ABMT), and 10 patients received autologous peripheral blood stem cell transplantation (APBSCT). After induction treatment 4 cases achieved complete response (CR) and 7 cases achieved partial response (PR). High dose chemotherapy combined with total body irradiation (TBI) or total lymph node irradiation(TLI)/subtotal lymph node irradiation(STLI) were applied in 7 cases and high dose chemotherapy alone was used in 4 cases as preparative treatment before transplantion. Five cases received complementary irradiation in the primary sites after transplant. Results: These cases who had been CR before transplant ation were consolidative therapy, and among the rest with PR, 2 cases achieved CR, 1 cases PR, and 4 cases stable disease(SD). Furthermore all these patients who maintained SD had bone involvement. With a median follow up of 13(1-84) months for all patients, all of them were alive at that time. Four cases were event free survival (EFS); Four cases with bone involvement are progression free survival (PFS). Three cases experienced relapse after transplant, one of them was EFS for 42 months again after a local relapsed site irradiation; the other two cases were being given further salvaged treatment now. According to the life tables method, the cumulati

关 键 词：霍奇金淋巴瘤 化学疗法 放射疗法 自体造血干细胞移植 

分 类 号：R733.1[医药卫生—肿瘤]