摘要
目的:探讨以BEAM方案为主的预处理后行自体外周血干细胞移植(APBSCT)对侵袭性非霍奇金淋巴瘤(NHL)的疗效。方法:诊断为侵袭性NHL患者54例,其中难治、复发NHL的挽救治疗41例,作为高危侵袭性NHL的一线缓解后治疗13例;经环磷酰胺加VP-16动员后行BEAM方案(51例)或CBV方案(3例)预处理的APBSCT。结果:1例未植活,3个月后行半相合异基因干细胞移植;2例患者死于移植相关的并发症,其余患者均获得造血功能重建;移植后外周血中性粒细胞绝对计数(ANC)≥0.5×109/L的中位时间为10d(平均8~25d);血小板≥20×109/L的中位时间为15d(平均6~36d)。随访时间为6~102个月,中位随访时间为42.5个月。中位生存时间为35个月(2~100个月),3年总生存率为66.6%,3年无病生存率为66.4%;Cox多因素分析显示,疾病的分期和血小板植活的时间与NHL患者APBSCT后的生存相关。结论:BEAM为主的预处理方案的APBSCT无论作为侵袭型NHL的挽救治疗或高危侵袭型NHL的一线缓解后治疗安全,疗效肯定。
Objective:To evaluate the therapeutic effectiveness and safety of autologous peripheral blood stem-cell transplantation(APBSCT)for patients with aggressive non-Hodgkin lymphoma(NHL).Method:Fifty-four patients with aggressive NHL were retrospectively reviewed and followed-up after receiving APBSCT conditioned with BEAM(51 cases)or CBV(3 cases).Result:One patient who failed to engraft received second transplant using haplo-identical donor;Two patients died from treatment related toxicity(TRM);The time of ANC≥0.5×109/L and platelet count≥20×109/L were at 10d(8-25 d)and 15 d(6-36 d)respectively.The median follow-up time was 42.5 months(6-102 months);The estimated 3-year overall survival(OS)is 66.6%;The estimated 3-year disease-free survival(DFS)is 66.4%;Cox multivariate analysis showed that the disease stage and the platelet engraftment time were correlated with survival of high risk aggressive NHL following APBSCT conditioned with BEAM.Conclusion:APBSCT using BEAM as conditioning regimens is a safe and effective therapy for aggressive non-Hodgkin lymphoma.It can be used either as salvage treatment or first-line consolidation for high risk aggressive non-Hodgkin lymphoma.
出处
《临床血液学杂志》
CAS
2012年第2期136-139,共4页
Journal of Clinical Hematology
关键词
淋巴瘤
非霍奇金
外周血干细胞移植
自体
预处理方案
lymphoma
non-Hodgkin
peripheral blood stem-cell transplantation
autologous
conditioning regimens