自体外周血造血干细胞移植术治疗淋巴瘤44例疗效分析

Efficacy of autologous hematopoietic stem cell transplantation for 44 patients with lymphoma

目的：评价自体造血干细胞移植（autologous hematopoietic stem cell transplantation，AHSCT）治疗淋巴瘤的临床疗效。方法：回顾分析我院干细胞移植中心44例行AHSCT的淋巴瘤患者临床资料。44例被诊断为淋巴瘤的患者在经过数个疗程的放化疗后达到完全缓解或部分缓解后在我院行自体干细胞移植后，随访治疗。结果：44例AHSCT治疗淋巴瘤患者中，有1例死于动员化疗后并发的真菌感染，其余43例均获得造血重建，中位随访时间为17个月（1～53个月）。43例移植成功患者中，存活32例（74％），死亡11例。11例死亡患者中9例（21％）复发后经过一段时间的姑息治疗后死亡，1例患者死于移植相关并发症，1例死于非移植相关并发症。患者截止随访时间时的总生存率和无病生存率均为72％。平均生存时间为（3．7±0．6）年，3年生存率为68％，估计5年生存率为51％。AHSCT后维持治疗者未见复发。结论：AHSCT治疗淋巴瘤具有技术条件成熟、适应证广泛、治疗效果显著的特点，是淋巴瘤治疗方案中的重要组成部分。

Objective：To evaluate the clinical efficacy of autologous hematopoietic stem cell transplantation （AHSCT） in the treatment of lymphoma. Methods ： Clinical data of 45 patients with lymphoma who received AHSCT in our hospital stem cell transplant cen- ter were retrospectively analyzed. All patients with lymphoma achieved complete remission or partial remission after several courses of radiotherapy and chemotherapy, and then they received AHSCT and follow-up treatment in our hospital. Results：Among 44 patients treated by AHSCT, 1 patient died of cardiac toxicity induced by cyclophosphamide in the pretreatment and the other 43 patients allobtained hematopoietic reconstitution;the median follow-up time was 17 （ 1-53） months. Thirty-two patients survived （ 74% ） and 11 died among the 43 patients who had successful AHSCT. Nine patients（21%） died in the period of palliative care afterrecurrence, 1 patient died of viral hepatitis B and 1 patient died of evans syndrome among the 11 died patients.Both the overall rate and disease-free survival rate was 72% until follow-up finished. Means survival time was （3.7± 0.6） years, 3-year survival rate was 68% and estimated 5-year survival rate was 51%. Conclusions ：With the advantages of ripe technical conditions,wide range of in- dications and significant treatment effect, AHSCT is the important part of treatment regimens for lymphoma.