大剂量化疗联合自体造血干细胞移植治疗68例淋巴瘤临床疗效分析  

Clinical analysis of high-dose chemotherapy combined with autologous hematopoietic stem cell transplantation for treatment of lymphoma

作　　者：孙艳[1] 郭莉[1] 胡欣[1] 朱娓[1] 杨顺娥[1] SUN Yan;GUO Li;HU Xin;ZHU Wei;YANG Shun-e(Lymphoma Internal Medicine , Xinjiang Tumor Hospital Affiliated to Xinjiang Medical University ,Urumqi 830011, P. R. China)

机构地区：[1]新疆医科大学附属新疆肿瘤医院淋巴瘤内科

出　　处：《中华肿瘤防治杂志》2019年第13期963-968,共6页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的大剂量化疗联合自体造血干细胞移植(high-dose chemotherapy/autologous hematopoietic stem celltransplantation,HDC/AHSCT)是目前治疗复发/难治侵袭性淋巴瘤的标准方案.然而,HDC/AHSCT作为淋巴瘤一线治疗的地位尚存在争议,为探讨该方案在淋巴瘤治疗中的临床疗效及安全性,就HDC/AHSCT治疗淋巴瘤的临床研究进展作系统回顾.方法回顾性分析2000-01-01-2017-12- 31就诊于新疆医科大学附属肿瘤医院行HDC/AHSCT治疗淋巴瘤患者的临床资料.患者男46例,女22例;年龄6~54岁,中位年龄29岁.其中霍奇金淋巴瘤14例,非霍奇金淋巴瘤54例.动员方案均采用化疗药物联合粒细胞集落刺激因子.62例患者采用BEAC(卡莫司汀+依托泊苷+阿糖胞苷+环磷酰胺)方案,6例患者采用BEAM方案(卡莫司汀+依托泊苷+阿糖胞苷+马法兰).结果 AHSCT前疾病获得完全缓解43例(63.24%),部分缓解25例(36.76%);AHSCT后疾病获得完全缓解59例(86.76%),部分缓解9例(13.24%).中位随访时间99(7~181)个月,1例患者失访.至随访结束,无进展生存44例,复发24例,死亡20例,19例死于复发.接受HDC/AHSCT治疗后3、5、10年总生存率分别为81.9%、73.2%和68.1%,3、5、10年无进展生存率分别为71.2%、65.1%和51.3%,无移植相关死亡.结论 HDC/AHSCT可提高淋巴瘤患者的治疗效果,且安全性高,可作为淋巴瘤的一种安全有效的治疗方式.OBJECTIVE High-dose therapy/autologous hematopoietic stem cell transplantation( HDT/AHSCT) is currently the standard protocol for the treatment of relapsed/refractory invasive lymphoma. However,the status of HDT/ AHSCT as a first-line treatment for lymphoma is still controversial. This study aimed to explore the clinical efficacy and safety of this regimen in the treatment of lymphoma, and systematically reviews the clinical progress of HDT/AHSCT in the treatment of lymphoma. METHODS Retrospective analysis of the clinical data of autologous hematopoietic stem cell transplantation for lymphoma patients in the Affiliated Cancer Hospital of Xinjiang Medical University from 2000-01-01 - 2017-12-31 was performed. Fourteen patients were with Hodgkin lymphoma ( HL) and 54 patients with non-Hodgkinz's lymphoma(NHL). There were 46 males and 22 females,The median age was 29(6-54) years old. The mobilization protocol was chemotherapy drugs combined with granulocyte colony-stimulating factor. BEAC( mustine-F cytarabine+ etoposide + Cyclophosphamide) in 62 patients,BEAM(mustine+ cytarabine+ etoposide+ melphalan) in 6 patients. RESULTS Totally 43 patients(63. 24%) achieved complete remission (OR) before transplantation and 25 patients (36. 76%) achieved partial remission before transplantation. However,59 patients(86. 76%) achieved complete remission after transplantation and 9 patients(13. 24%) achieved partial remission. At a median follow-up of 99 months (7- 181 months),one patient was lost to follow-up. Totally 44 cases received progression-free survival after transplantation,24 cases received recurrence after transplantation and 20 cases died. The 3-year,5-year and 10-year overall survival rates of patients treated with highdose chemotherapy combined with autologous hematopoietic stem cell transplantation were 81. 9%,73. 2% and 68. 1 %,respectively. In addition,the 3-year,5-year and 10-year progression-free survival rates were 71. 2%,65. 1 % and 51. 3%, respectively. None of the patients was dead for transplantation. CONC

关 键 词：淋巴瘤 自体造血干细胞移植 疗效 安全性 

分 类 号：R733[医药卫生—肿瘤]