自体造血干细胞移植治疗高危难治淋巴瘤生存分析  

Survival analysis of patients with high risk refractory lymphoma treated by autologous hematopoietic stem cell transplantation

作　　者：蒲欣[1] 陈洁平[1] 

机构地区：[1]第三军医大学西南医院血液病中心,重庆400038

出　　处：《重庆医学》2016年第12期1620-1623,1626,共5页Chongqing medicine

基　　金：国家自然科学基金资助项目(39870046;81470324;81270605;30971066);重庆市自然科学基金重点项目(CSTC;2008BA5001);第三军医大学重大临床科研课题(2012XLC03);重庆研究生教育改革项目(yjp123114);军事医学科学研究基金重点项目(BWS3C018)

摘　　要：目的探讨高危难治淋巴瘤患者自体外周血造血(APBSCT)干细胞移植治疗后的预后与生存情况。方法回顾性分析该院110例高危难治淋巴瘤行APBSCT患者的随访资料,采用Kaplan-Meier生存分析和Cox比例风险回归法分析影响患者APBSCT治疗后的生存及预后因素。结果 110例患者中位生存时间39.4个月,移植后3年总生存(OS)率及无进展生存(PFS)率分别为80.9%和76.4%。移植前完全缓解(CR)状态(P=0.016)、移植后巩固治疗(P=0.006)的高危难治淋巴瘤APBSCT患者预后良好;而IPI评分大于2分、血清乳酸脱氢酶(LDH)偏高、骨髓浸润、乙型肝炎病毒(HBV)感染的高危难治淋巴瘤APBSCT患者预后差(P<0.05)。结论高危难治淋巴瘤患者行APBSCT治疗可以提高远期生存率。Objective To investigate the prognosis and survival situation of the patients with high risk refractory lymphoma treated by autologous hematopoietic stem cell transplantation.Methods The follow up data in 110 patients with high risk refractory lymphoma treated by autologous hematopoietic stem cell transplantation in our hospital were retrospectively analyzed.The survival and prognosis factors of the patients after autologous hematopoietic stem cell transplantation were analyzed by using the KaplanMeier survival analysis and Cox proportional hazard regression analysis.Results The median survival time was 39.4months in 110 cases,the 3-year overall survival rate（OS）and progression free survival rate（PFS）were 80.9% and 76.4%respectively.The patients achieved CR status before transplantation（P=0.016）and consolidation therapy after transplantation（P=0.006）were the favorable prognostic factors of the patients undergoing transplantation.The prognosis in the patients with high LDH values,IPI score〉2 and bone marrow infiltration and HBV infection were poor（P〈0.05）.Conclusion Autologous hematopoietic stem cell transplantation can improve the long-term survival rate in the patients with high risk refractory lymphoma.

关 键 词：造血干细胞移植 淋巴瘤 移植 自体 预后 

分 类 号：R733.1[医药卫生—肿瘤]