自体造血干细胞移植治疗弥漫大B细胞淋巴瘤效果

AUTOLOGOUS STEM CELL TRANSPLANTATION IN PATIENTS WITH DIFFUSE LARGE B-CELL LYMPHOMA

目的观察自体造血干细胞移植治疗弥漫大B细胞淋巴瘤（DLBCL）病人的效果。方法复发和具有不良预后因素的DLBCL病人18例,经BEAM（卡氮芥、依托泊苷、阿糖胞苷、环磷酰胺）、BEAC（卡氮芥、马法兰、依托泊苷、阿糖胞苷）或FEAC（氟达拉滨、依托泊苷、阿糖胞苷、环磷酰胺）方案预处理后,采取自体造血干细胞移植治疗。对其治疗结果进行回顾性分析。结果 18例病人均获快速造血功能重建,中性粒细胞≥0.5×10^9/L的时间为7-19d,平均12d;血小板≥20×10^9/L的时间为7-25d,平均15d。所有病人的中位观测时间为42个月（11-71个月）,中位生存时间为25个月,3年总生存率为61.1%,3年无进展生存率为55.5%。8例复发病人中,总生存率为62.5%;10例具有不良预后因素的DLBCL病人,第1次完全缓解后接受自体造血干细胞移植,3年无进展生存率为60.0%,3年总生存率为70.0%。结论自体造血干细胞移植是治疗预后不良和复发DLBCL安全有效的方法。

Objective To assess the effect of autologous stem cell transplantion（ASCT）on patients with diffuse large Bcell lymphoma（DLBCL）. Methods Eighteen DLBCL patients with potential factors of recurrence and poor prognosis after pretreatment with BEAM（Carmustine, etoposide, cyclophosphamide, cytarabine）,BEAC（Carmustine,etoposide,melphalan,AraC）or FEAC（Fludarabine, cytarabine, etoposide,cyclophosphamide）program were treated with ASCT.The therapeutic outcomes were retrospectively reviewed. Results All the 18 patients obtained quick reconstruction of blood-producing function,neutrophils≥0.5×10^9/L time（mean）was 12d（7-19d）,platelets ≥20×10^9/L time（mean）was 15d（7-25d）.The median（mean）observation time was 42（11-71）months,the median survival time was 25 months,3-year overall survival rate was61.1%,and 3-year progression-free survival was 55.5%.In eight patients with recurrence,the overall survival rate was 62.5%;in10patients who had poor prognostic factors received ASCT after the first complete remission,their 3-year progression-free survival was 60.0%,and 3-year overall survival was 70.0%. Conclusion Autologous stem cell transplantion is safe and effective for patients suffering from diffuse large B-cell lymphoma with poor prognosis and recurrence.