自体外周血造血干细胞移植联合大剂量化疗治疗套细胞淋巴瘤的临床观察

Clinical Observation on the Autologous Peripheral Blood Stem Cells Transplantation plus Intensive Chemotherapy in the Treatment of Mantle Cell Lymphoma

目的探讨自体外周血造血干细胞移植（ASCT）联合大剂量化疗治疗套细胞淋巴瘤的临床疗效及安全性。方法总结2000年1月-2011年1月进行的自体外周造血干细胞移植联合大剂量化疗的28例套细胞淋巴瘤患者（移植组）的临床资料,并与同期28例接受常规治疗的套细胞淋巴瘤患者（常规化疗组）进行比较。结果移植组CR为67.9%,PR为32.1%,常规化疗组CR为57.1%,PR为42.9%,两组总有效率比较,差异无统计学意义（P〉0.05）;移植组5年OS（65%）显著高于常规化疗组（42%）,5年DFS（53%）亦高于常规化疗组（34%）,差异均有统计学意义（P〈0.05）。移植组Ⅳ度骨髓抑制的发生率（100%）明显高于常规化疗组（17.9%）,差异有统计学意义（P〈0.05）。结论 ASCT支持下大剂量化疗治疗套细胞淋巴瘤的临床疗效好于常规化疗,且安全性较高。

Objective To investigate the clinical efficacy and safety of autologous peripheral blood stem cells transplantation（ASCT） plus intensive chemotherapy in the treatment of mantle cell lymphoma（MCL）. Methods The clinical data of 28 cases of MCL patients who were treated with first-line intensive chemotherapy followed by ASCT were collected and compared with that of 28 cases of MCL patients who were treated with conventional chemotherapy between January 2000 and January 2011. All patients had received EPOCH for 6-8 cycles, and autologous stem cell transplantation group were administrated with intensive chemotherapy followed by ASCT after complete remission or partial remission. Results The CR and PR were respectively 67.9% and 32.1% in ASCT group, and were 57.1% and 42.9% in the conventional chemotherapy group. There was no statistical significance between two groups（all P〈0.05）. But the 5-year OS of ASCT group was significantly higher than that of the conventional chemotherapy group（65% vs.42%）, as well as the 5-year DFS（53% vs.34%）,（all P〉0.05）. Only the incidence rate of Ⅳ° myelosuppression in ASCT group was higher than that in conventional chemotherapy group（100% vs.17.9%）（P〈0.05）. Conclusion The intensive chemotherapy followed by ASCT had better clinical efficacy than conventional chemotherapy in the treatment of MCL, with relatively higher safety.