自体外周血造血干细胞移植治疗非霍奇金淋巴瘤的临床效果

Clinical effect of autologous peripheral blood stem cell transplantation in treatment of non-Hodgkin lymphoma

目的探讨自体外周血造血干细胞移植（auto—PBSCT）治疗非霍奇金淋巴瘤（NHL）的临床效果。方法选择第三军医大学大坪医院野战外科研究所2006年6月～2014年12月进行auto—PBSCT、临床分期Ⅲ、Ⅳ期的37例NHL患者，平均年龄45．7（8～68）岁。37例诊断明确的NHL患者，在经过4～8个疗程的化疗和戚局部放射治疗后行auto—PBSCT，术后定期随访。结果37例患者均获得造血功能重建，移植术后完全缓解率（CR）为70．3％，部分缓解率（PR）为16．2％，总有效率（RR）为86．5％（CR＋PR）；随访时间2～93个月，中位随访时间30．5个月。截至随访时间，25例（69．4％）患者生存，11例（30．6％）死亡，1例失访。11例死亡患者中9例（81．8％）因疾病复发或进展死亡，1例（9．09％）因肝炎肝功能衰竭死亡，1例（9．09％）患者维持治疗中并发多器官功能衰竭死亡。骨髓受浸润的5例患者auto—PBSCT术后3例（60．0％）完全缓解，术后生存期最长者达52个月。结论auto—PBSCT是治疗NHL、甚至有骨髓浸润患者的有效方案，能延长患者的生存期；淋巴瘤的分期、是否有骨髓浸润是影响疗效及生存期的因素；疗效与淋巴瘤的疾病类型无关。

Objective To investigate the clinical effect of autologous peripheral blood stem cell transplantation （auto- PBSCT） in treatment of non-Hodgkin lymphoma （NHL）. Methods 37 cases of NHL with auto-PBSCT therapy and Ⅲ, Ⅳ clinical stage from June 2006 to December 2014 in Daping Hospital and the Research Institute of Surgery of the Third Military Medical University were selected. The patients＇ average age was 45.7 （8-68） years old. All 37 patients with NHL were treated with auto-PBSCT after 4-8 courses of chemotherapy and/or local radiotherapy. The patients were regularly followed-up. Results The hematopoietic function was reconstructed in all the 37 patients. The rate of complete remission （CR） after the transplant was 70.3%, the rate of partial remission （PR） was 16.2%, the total effective rate was 86.5% （CR＋PR）. The follow-up time was 2-93 months, the median follow-up time was 30.5 months. 25 cases （69.4%） of survival, 11 cases （30.6%） of death and 1 case of loss were found. Among the 11 cases of death, 9 cases （81.8%） of disease recurrence or progression, 1 case （9.09%） of hepatic failure, 1 case （9.09%） of multiple organ failure were found. 3 cases （60.0%） of CR after the auto-PBSCT were found in 5 cases of bone marrow infiltration, the longest postoperative survival was 52 months. Conclusion Auto-HSCT is an effective solution in the treatment of NHL, bone marrow infiltration, it can improve the lifetime. The lymphoma staging, bone marrow infiltration are the influence elements of curative effect and survival, the curative effect has no correlation with disease types of lymphoma.