自体外周血干细胞移植治疗恶性淋巴瘤的临床研究

Clinical analysis of autologous peripheral blood stem cell transplantation in patients with malignant Lymphoma

目的:探讨白体外周血干细胞移植(APBSCT)联合超大剂量化放疗治疗恶性淋巴瘤的造血重建及疗效。方法:18例恶性淋巴瘤经常规化疗完全或部分缓解后行APBSCT治疗,动员方案为VP-16 1 500 mg/m2+ G-CSF 5μg/kg。预处理方案:1例采用单一化疗药物环磷酰胺(CTX)3．6 g/m2加全身放疗,其余17例采用BE- AC+BCNU 450 mg/m2+CTX3．6 g/m2+Ara-C 1．5 g/m2+VP-16 800 mg/m2方案。结果:18例患者行APB SCT治疗后均移植成功,重建造血功能,其中1例患者干细胞移植后血常规尚未完全恢复正常,其余17例均于干细胞移植后30 d内恢复正常。移植前14例病变达CR,4例达PR,移植后17例达CR,1例达PR。随访10(1-56) 个月,所有患者均存活,无移植相关死亡。结论:APBSCT联合超大剂量化疗是治疗恶性淋巴瘤的安全有效手段, 值得进一步研究推广。

Objectives： To investigate the effect and safety of high dose chemotherapy （HDC） with autologous peripheral blood stem cell transplantation （APBSCT） in treating malignant lymphoma. Methods： 18 malignant lymphoma patients were treated with high dose chemoradiotherapy with APBSCT, there were 15 cases with non-hodgkin＇s lymphoma and 3 with Hodgkin＇s lymphoma. Primary treatment.1 NHL was CTX 3.6 g/m^2＋total body irradiation. Others were CTX 3.6 g/m^2 , Ara-C 1.5 g/m^2 , VP-16 800 mg/m^z, BCNU 450 mg/m^2, and complementary irradiation in the primary sites after transplantation. Results. After mobilization, the numbers of mono-nucler cell （MNC） and CD34＋were 4.59 ）〈 10^8/kg（range, 3.42× 10^8/kg～7.46× 10^8/kg）, 5.15 × 10^6/kg（range, 1.74 × 10^6/kg～10. 81 ×10^6/kg） respectively in this study. Among these patients, 17 cases achieved complete response（CR） and 1 case achieved partial response （PR）. The median follow up time was 10 （range,1-56） months. All of patients were alive at that time. Conclusions. HDC combined with APBSCT is a safe and effective method in the treatment of malignant lymphoma and worth to further clinical study.