自体干细胞移植支持下的大剂量化疗治疗侵袭性非霍奇金淋巴瘤

Treatment effect of high-dose chemotherapy with autologous stem cell transplantation on patients with aggressive non-Hodgkin's lymphoma

目的:探讨自体血干细胞移植(ASCT)支持下的大剂量化疗(HDC)治疗侵袭性非霍奇金淋巴瘤(NHL)的疗效。方法:23例侵袭性NHL患者经过3～7周期常规化疗疗效达完全或部分缓解后行自体外周血干细胞动员,大剂量化疗方案采用BEAC(BCNU450mg/m2,VP-16800mg/m2,Ara-C1.5g/m2,CTX3.6g/m2)方案。结果:23例患者均移植成功,重建造血功能,无移植相关死亡。移植前9例达CR或CRu,14例达PR;移植后13例达CR或CRu,10例达PR。全部病例均得到随访,中位随访时间为29个月(1个～84个月),移植后3例病情进展,其中1例死亡,3年的无进展生存率为79.4%。结论:HDC/ASCT治疗侵袭性NHL是有效的治疗方法。

Objective： To investigate the efficacy of high-dose chemotherapy （HDC） with autologous stem cell transplantation （ASCT） for patients with aggressive non Hodgkin＇s lymphoma （NHL）. Methods： Between April 2000 and July 2007, twenty-three eligible patients with aggressive NHL underwent the HDC/ ASCT therapy. The median age at ASCT was 32 years （range, 8-60 years）. The conditioning consisted of BEAC （BCNU, VP 16, Ara-C, CTX） regimen. Results： The median follow-up duration from transplantation was 29 months （range, 1-84 months）. Prior to HDC/ASCT, Nine patients were in complete remission （CR） or complete remission unconfirmed （CRu） and Fourteen patients were in partial remission（PR）. After HDC/ASCT, Thirteen patients achieved CR or CRu and Ten patients achieved PR. Twenty-two patients were alive; One patient died of progressive disease. Estimated three-year progression-free survival （PFS） were 79.4%. Conclusions： HDC/ASCT is effective for patients with aggressive NHL. A prospective randomized controlled trial is warranted to confirm these results .