自体外周血干细胞移植联合过继免疫治疗霍奇金淋巴瘤的临床分析  

Clinical analysis of autologous peripheral blood stem cell transplantation combined adoptive immunotherapy in Hodgkin's lymphoma

作　　者：王存邦[1] 白海[1] 葸瑞[1] 潘耀柱[1] 徐淑芬[1] 张茜[1] 陈燕[1] 周进茂[1] 吴涛[1] 

机构地区：[1]兰州军区兰州总医院血液科全军血液病中心,兰州730050

出　　处：《临床血液学杂志》2015年第6期939-942,共4页Journal of Clinical Hematology

摘　　要：目的:探讨自体外周血干细胞移植(APBSCT)联合过继免疫治疗霍奇金淋巴瘤(HL)的疗效。方法:以32例HL患者作为治疗组,交替应用ABVD方案、TAOP方案和MEOP方案各2个疗程化疗后,以化疗+重组人粒细胞集落刺激因子方法动员自体外周血干细胞,TBI+VEMAC方案预处理,进行APBSCT。造血恢复后每个月给予重组人白细胞介素-2 100 WU/d×10d的过继免疫治疗,共6个疗程。以22例HL患者作为对照组,化疗及移植方案同上,未给予后续治疗。随访时间5年。结果:2组患者移植后1个月内均实现造血重建并全部处于完全缓解。随访1年时,2组患者的无病生存(DFS)率均为100%(P>0.05),随访3年、5年时,2组的DFS率分别为93.8%、84.4%和72.7%、59.1%,差异有统计学意义(P<0.05)。随访1年时,2组间Ⅲ/Ⅳ期患者的DFS率均为100%(P>0.05),随访3年、5年时,2组间Ⅲ/Ⅳ期患者的DFS率分别为91.3%、82.6%和64.7%、52.9%,差异有统计学意义(P<0.05)。结论:APBSCT联合过继免疫治疗HL疗效显著,尤其Ⅲ/Ⅳ期患者获益明显。Objective：To investigate the efficacy treated with autologous peripheral blood stem cell transplantation（APBSCT）combined adoptive immunotherapy for Hodgkin＇s lymphoma（HL）.Method：A total of 32 cases diagnosed HL as treatment group,and they were treated sequentially with chemotherapy regimens（ABVD,TAOP,MEOP）for 2courses respectively.After that,APBSC were mobilized with chemotherapy combined rhG-CSF,and all the patients received APBSCT after conditioning regimen with TBI combined VEMAC.After hematopoietic reconstruction,they were given 6courses adoptive immunotherapy（rhIL-2 100 WU/d for 10 days monthly for each course）.Twenty-two cases of HL patients as control group,they received chemotherapy regimens and APBSCT only,but no rhIL-2adoptive immunotherapy.All patients were followed-up 5years.Result：All patients in two groups achieved hematopoietic reconstruction and were in a state of complete remission in a month after transplantation.Followed up 1year,DFS rates of patients in treatment and control group both were 100%（P〉0.05）.Followed up 3and 5years,DFS rates in two groups were 93.8%,84.4% and 72.7%,59.1% respectively（P〈0.05）.Followed up 1year,DFS rates of patients in phaseⅢ/Ⅳ of two groups both were 100%（P〉0.05）.Followed up 3and 5years,DFS rates in two group patients with phase Ⅲ/Ⅳ were 91.3%,82.6% and 64.7%,52.9%respectively（P〈0.05）.Conclusion：There is obvious efficacy to patients of HL treated with APBSCT combined adoptive immunotherapy,especially to patients with phaseⅢ/Ⅳ.

关 键 词：霍奇金淋巴瘤 自体外周血干细胞移植 过继免疫治疗 疗效 

分 类 号：R733.4[医药卫生—肿瘤]