自体造血干细胞移植治疗中、高度恶性淋巴瘤  

Treatment of Moderate-Grade and High-Grade Malignant Lymphoma with Autologous Hematopoietic Stem Cell Transplantation

作　　者：汪安兰[1] 何执鼎[1] 罗以[1] 肖立新[1] 刘晰宇[1] 朱跃红[1] 

机构地区：[1]湖南省肿瘤医院,湖南长沙410006

出　　处：《癌症》2003年第12期1317-1320,共4页Chinese Journal of Cancer

基　　金：湖南省科委社会发展基金项目(No.97SSY1037)

摘　　要：背景与目的:自体造血干细胞移植(autologoushemotopoieticstemcelltransplantation,ASCT)支持下的大剂量化疗目前已成为治疗对化疗敏感的淋巴瘤最有效的手段之一。本研究评价自体造血干细胞移植支持下的大剂量化疗加放疗治疗预后差的中、高度恶性淋巴瘤的疗效。方法:1995年11月～2001年5月收集到的13例病例中,非霍奇金淋巴瘤(non-Hodgkinslymphoma,NHL)11例,复发霍奇金淋巴瘤(Hodgkinsdisease,HD)2例。移植前首次完全缓解(firstcompleteremission,CR1)8例,第二次完全缓解(secondcompleteremission,CR2)4例,第二次部分缓解(secondpartialremission,PR2)1例。预处理方案:单纯化疗4例;化疗加受累区放疗6例;全身放疗加化疗3例。2例采用自体骨髓移植,11例行自体外周血干细胞移植。结果:本组病例回输单核细胞(mono-nuclearcell,MNC)和粒-巨细胞系祖细胞(granulocyte-macrophagecolony-formingcells,CFU-GM)的均数(范围)分别为2.55(2.07～3.31)×109/L和1.43(0.6～2.36)×109/L。随访到2001年10月,所有患者造血功能都获得重建。白细胞恢复到≥1.0×109/L和血小板>50×109/L的中位时间(范围)分别为6(7～35)天和8(6～32)天。CR持续时间为4～57个月,中位时间为16个月,1年生存率76.9%,3年生存率46.2%。结论:自体造?BACKGROUND &OBJECTIVE: High dose chemotherapy (HDCT) supported by autologous hematopoietic stem cell transplantation (ASCT) is one of the most ef fective approaches for the chemo-sensitive lymphoma. The purpose of this study was to investigate the effectiveness of HDCT combined with radiotherapy supporte d by HSCT in treatment of poor-prognostic moderate-grade and high-grade malig nant lymphoma. METHODS: Eleven patients [11 cases of non-Hodgkins lymphoma (N HL) and 2 cases of recurrent Hodgkins lymphoma (HD)] were enrolled from Decemb er 1995 to May 2001. Status on ASCT was 8 cases with 1st complete remission (CR1 ), 4 cases with second complete remission (CR2), 1 case with second partial remi ssion (PR2). The preparative regimens consisted of HDCT alone (4 patients), HDCT with involved-field (IF) radiotherapy (6 patients), total body irradiation (TB I) with HDCT (3 patients). Two patients were supported by bone marrow transplant ation (ABMT) and 11 by autologous peripheral blood stem cell transplantation (AP BSCT). RESULTS:The numbers of mono-nuclear cell (MNC) and granulocyte-macropha ge colony-forming cells (CFU-GM) reinfused were 2.55(range, 2.07-3.31)×109/L , 1.43(range, 0.6-2.36)×109/L in this study, respectively. Hematopoietic recon stitution was observed in all patients when they were followed-up on October 20 01. WBC≥1.0×109/L and Platelet >50×109/L were at day 6 (range,7-35) and day 8 (range,6-32), respectively. The median CR duration was 16 months (range, 4-5 7 months). The 1-and 3-year survival rates were 76.9%and 46.2%, respectively . CONCLUSION: HDCT with ASCT is valuable to treatment in patients with chemo-se nsitive moderate-grade and high-grade NHL and recurrent HD.

关 键 词：自体造血干细胞移植 治疗 恶性淋巴瘤 药物疗法 

分 类 号：R733.1[医药卫生—肿瘤]