造血干细胞移植治疗实体瘤20例随访报告

Report of lone term follow up in 20 patients with solid tumor in hematopoietic stem cell transplantation

目的 :长期随访并综合评价自体造血干细胞移植治疗恶性实体瘤的治疗效果、安全性及可行性。方法 :2 0例实体瘤患者自体骨髓移植 6例 ,自体外周血造血干细胞移植 14例 ,预处理方案为全身照射加大剂量化疗或大剂量化疗 ,动态观察移植后治疗效果、生活质量及移植相关并发症。结果 :2 0例中完全缓解 12例 (60 % ) ,部分缓解 3例 (15 % ) ,总体治疗反应率 75 % ,中位随访时间 16个月 (4～ 3 2个月 ) ,生活质量Karaofsky评分 10 0分 13例 ,80～ 90分 3例 ,80分以下仅 3例。移植相关并发症以感染和消化道毒副作用常见。移植相关死亡 2例 (10 % )。结论 :自体造血干细胞移植可提高恶性实体瘤的缓解率 ,延长无病生存期 ,严重相关并发症少 。

Objective: To assess the therapeutic effectiveness,safety and feasibility for the treatment of hematopoietic stem cell transplantation in solid tumor by lone term follow up.Methods: Of the 20 patients,6 patients were in ABMT and 14 patients in PBSCT.Preparative regiment composed of total body irradiation and intensive chemotherapy or intensive chemotherapy only.To monitor the therapeutic effectiveness,live quality and related complication after transplantation.Results: 12 patients achieved CR(60%),3 patients in PR(15%),overall response 75%.The median period of follow up was 16 months(4 32).Karnofsky score to estimate life quality was 100 in 13 patients,80 90 in 3 patients,less than 80 in 4 patients.Transplant related complication was frequently in infection and side effect of alimentary canal.Death related to the transplant occurred in 2 patients.Conclusion: The treatment of autologus hematopoietic stem cell transplantation can improve the CR rate and DFS of the patients with solid tumors.It was lower to experience in serious complication related transplantation.Life quality was good after transplantation.