摘要
Objective To evaluate the long-term therapeutic effects of autologous peripheral blood stem cell transplantation (auto-PBSCT) on the treatment of hematological and solid tumors.Methods Fifty-one patients were recruited in this auto-PBSCT study, in which several potentially important parameters were studied including the optimal time for stem cell collection, the dose of stem cell reinfusion, the time of hematopoietic reconstitution, the disease free survival (DFS) and overall survival (OS), complications related to transplantation, and maintenance chemotherapy after auto-PBSCT.Results After APBSCT, 3-year and 5-year survival rates of NHL were 83.3%; those of AML were 74.7%; those of MM were 37.9% and 19%; those of ALL were 40% and 0% respectively. Hematopoietic reconstitution was greatly promoted by granulocyte colony stimulating factor (G-CSF). The mean time for patients' neutrophil to recover up to >0.5×109/L after APBSCT was 11.14 days in the group of the patients receiving G-CSF in contrast to 17.6 days in the group receiving no G-CSF. The most common complications of transplantation were fever, liver dysfunction and hypokalaemia, which were curable. No death was due to transplantation related complications.Conclusion Comparing with conventional chemotherapy, our study suggests that auto-PBSCT is a very important therapeutic option that can significantly improve the prognosis in the patients with hematological and solid tumors, especially in the patients with AML and NHL.
目的 回顾性分析自体外周血干细胞移植 (APBSCT)治疗血液恶性病及实体瘤的疗效。方法 51例患血液及实体肿瘤患者接受自体外周血干细胞移植 ,本文就移植过程中干细胞采集时间、干细胞回输量、骨髓重建时间、移植后各类疾病无病生存期及总体生存期、移植相关并发症、移植后维持化疗等问题进行总结和探讨。结果 (1)与常规化疗相比 ,自体外周血干细胞移植可延长移植患者的总体生存期及无病生存期 ,其顺序为NHL>AML >MM >ALL ;3年及 5年生存率AML和NHL组分别为 74 78%和 83 33% ,MM组为 38 0 %和 19 0 % ,ALL组为 4 0 0 %和 0 %。 (2 )移植后骨髓造血重建时间未用G CSF组干细胞回输后平均第 17 6天外周血白细胞恢复至 >0 5× 10 9/L ,用G CSF组平均 11 14天。 (3)移植相关并发症以发热 ,肝功能受损和低钾最常见。经治疗上述并发症均可逆转 ,尚未发现VOD或不可逆性肝损害 ,无移植相关死亡。移植后随访 7年中 ,共死亡 2 1例 ,其中 2 0例死于复发 ,主要为ALL和MM患者。结论 APBSCT已成为治疗血液恶性病及某些实体瘤、改善其预后的重要手段 。
