ChiCGB方案对非霍奇金淋巴瘤行自体造血干细胞移植的预处理效果  

Pretreatment effect of ChiCGB regimen in autologous hematopoietic stem cell transplantation for non-Hodgkin’s lymphoma

作　　者：陈莉[1] 王凌云[1] 郭彩玲[1] 熊际群 罗梦 CHEN Li;WANG Lingyun;GUO Cailing;XIONG Jiqun;LUO Meng(Department of Hematology, West China Hospital, Sichuan University, Chengdu 610041, China;Department of Rheumatology, West China Hospital, Sichuan University, Chengdu 610041, China)

机构地区：[1]四川大学华西医院血液内科,四川成都610041 [2]四川大学华西医院风湿免疫科,四川成都610041

出　　处：《西部医学》2021年第3期400-405,共6页Medical Journal of West China

摘　　要：目的探究非霍奇金淋巴瘤(NHL)患者进行自体造血干细胞移植前行西达本胺+克拉屈滨+吉西他滨+白消安(ChiCGB)方案的预处理效果。方法选择我院2015年3月~2019年7月收治的66例NHL患者相关资料进行回顾性分析,患者均行自体造血干细胞移植,移植前采用ChiCGB方案预处理。分析自体造血干细胞采集情况、移植完成后造血重建情况、预处理毒性、患者疗效以及生存情况。结果患者采集单核细胞及CD34+细胞中位数分别为11.36×108/kg和13.68×106/kg;66例患者均顺利完成造血重建,粒细胞平均植入时间(10.32±3.14)d;血小板平均植入时间(12.28±5.06)d;患者移植期间感染发生率为56.06%,移植过程中2级及以上出血、黏膜炎、肝损伤、腹泻、发热、恶心呕吐发生率分别为7.58%、25.76%、25.76%、56.06%、36.36%、66.67%;3个月达到完全缓解和部分缓解患者分别为46例和17例,患者移植后总反应率为95.45%;患者1年OS率和PFS率分别为84.85%和71.21%,3年OS率和PFS率分别为72.73%和60.61%;单因素与COX回归分析结果显示,疾病分期、难治性或者复发性疾病为影响患者3年OS率的独立危险因素(P<0.05);疾病分期是影响患者3年PFS率的独立危险因素(P<0.05)。结论NHL患者行自体造血干细胞移植前采用ChiCGB方案预处理无不可接受预处理毒性,同时患者预后较好,是自体造血干细胞移植患者安全有效的预处理方案。Objective To investigate the effects of conditioning with ChiCGB(chidamide+cladribine+gemcitabine+busulfan)in patients with non-Hodgkin's lymphoma(NHL)before autologous hematopoietic stem cell transplantation.Methods The relevant data of 66 patients with NHL admitted to the hospital between March 2015 and July 2019 were retrospectively analyzed.All patients were treated with autologous hematopoietic stem cell transplantation and conditioning with ChiCGB regimen before transplantation.The collection of autologous hematopoietic stem cells,hematopoietic reconstruction after transplantation,regimen-related toxicity,curative effect and survival were analyzed.Results The medians of collected mononuclear cells and CD34+cells were 11.36×108/kg and 13.68×106/kg,respectively.66 patients successfully completed hematopoietic reconstruction,and the average granulocyte implantation time and average platelet implantation time was(10.32±3.14)d and(12.28±7.06)d,respectively.The incidence of infection during transplantation was 56.06%,and the incidence rates of grade 2 or higher grade of bleeding,mucositis,liver injury,diarrhea,fever,nausea and vomiting during transplantation were 7.58%,25.76%,25.76%,56.06%,36.36%and 66.67%,respectively.46 and 17 patients achieved complete remission and partial remission in 3 months,respectively,and the overall response rate after transplantation was 95.45%.The 1-year OS rate and PFS rate were 84.85%and 71.21%.The 3-year OS rate and PFS rate were 72.73%and 60.61%,respectively.Univariate and COX regression analyses showed that disease stage and refractory or recurrent disease were independent risk factors affecting patients’3-year OS rate(P<0.05).Disease stage was an independent risk factor for the 3-year PFS rate(P<0.05).Conclusion There is no intolerable toxicity caused by conditioning with ChiCGB regimen in patients with NHL before autologous hematopoietic stem cell transplantation.Besides,the prognosis is good.It is a safe and effective conditioning regimen for such patients.

关 键 词：ChiCGB方案 非霍奇金淋巴瘤 自体造血干细胞移植 预处理效果 

分 类 号：R733[医药卫生—肿瘤]