自体造血干细胞移植治疗结外NK/T细胞淋巴瘤鼻型9例临床分析

Treatment of extranode nasal-type NK/T cell lymphoma with autologous peripheral blood stem cell transplantation(APBSCT): 9 cases′ clinical analysis

目的观察放/化疗加APBSCT治疗NK/T细胞淋巴瘤鼻型的疗效。方法用CHOP＋Lasp方案1个疗程、CHOP（或MOED、COED）＋HD-MTX方案化疗2～3个疗程，行干细胞动员、采集，CEAC方案预处理及APBSCT及移植后局部病灶的放疗；病程中共行3次鞘内注射化疗药，6～8次联合化疗。结果Ⅰ～Ⅱ期患者移植后1年生存率55.6%（5/9例），2年生存率为44.4%（4/9例）；Ⅲ～Ⅳ期患者移植后3个月～1年内由CR到病情复发，死亡4例，2年生存率为0。结论NK/T细胞淋巴瘤鼻型分期晚的治疗效果差，大剂量化/放疗＋APBSCT治疗NK/TCL可能是有效的措施之一。

Objective To observe the therapeutic effect for treatment of extranode nasal-type NK/T cell lymphoma with APBSCT combined with radiotherapy and chemotherapy. Methods After 1 course of CHOP＋ Laspl chemotherapy and 2 courses of CHOP（or MOED.COED）＋HD-MTX chemotherapy, to mobilize and collecte the stem cells, and then use CEAC chemotherapy for pretreatment. During the therapeutic period, 3 times＇ intrathecal injection chemotherapy and 6--8 chemotherapies were needed, and after transplantation, the local lesion＇s radiotherapy was needed. Results One year survival rate of Ⅰ -Ⅱ phase patients was 55.6%（5/9）, two year survival rate of Ⅰ -Ⅱ phase patients was 44.4%（4/9）. Patients in Ⅲ - Ⅳ phases usually relapsed in 1 year and 4 patients died, the two year survival rate was 0. Conclusion NK/T cell lymphoma in advanced stage always has poor therapeutic effect, the APBSCT combined with high-dose chemotherapy and radiotherapy may be an effective treatment for the disease.