自体骨髓移植治疗淋巴瘤合并自身免疫性疾病的探讨

The relationship between lymphoma after auto-bone marrow transplantation and autoimmune disease

目的探讨淋巴瘤并发类风湿关节炎（RA）患者进行白体骨髓移植治疗的疗效、安全性及移植后免疫重建过程。方法对1例临床诊断非霍奇金淋巴瘤（NHL）ⅢB、RA患者，诱导治疗反应良好后，行预处理方案BCEA，回输白体骨髓，给予粒细胞集落刺激因子（G-CSF）等综合治疗，术后补行选择性淋巴结放疗，观察移植前后患者的临床表现、实验室指标的变化及免疫重建的过程。结果移植后28d造血功能恢复，2个月后关节肿全部消失，红细胞沉降率正常，CRP、IgMRF均转为阴性。患者出院后3个月恢复正常工作，随访13年NHL及RA无复发。结论淋巴瘤并发RA患者进行白体骨髓移植治疗安全性好，中短期疗效显著，为淋巴瘤并发其他自身免疫病的治疗提供了新的可选择的治疗方法。

Objective To investigate therapeutic effect, safety and post transplant immunological reconstitution for patients of lymphoma after autologous bone marrow transplantation and occurrence of Rheumatoid Arthritis. Methods The clinical situation, laboratory index and immunological reconstitution was observed for patients of lymphoma after inductive treatment, BCEA of pretreatment, autologous bone marrow transfusion, G-CSF and radiotherapy to lymph node. Results Recovery of hemopoiesis was observed after 28 days. Disappearance of joint swelling and negative ESR, CRP, IgMRF were observed after 2 months. The patients started to work after 3 months. No recurrence of lymphoma and Rheumatoid Arthritis has been observed until today. Conclusion The autologous bone marrow transplantation was safe and effective for the treatment to patient of lymphoma with rheumatoid arthritis, which was a new method for the treatment to lymphoma and other autoallergic diseases.