摘要
目的:分析影响高危难治淋巴瘤患者自体外周血造血干细胞移植(auto-PBHSCT)治疗后生存和预后的相关因素。方法:对在本院行auto-PBHSCT治疗的96例高危难治淋巴瘤患者的总生存率应用Kapan-Meier曲线和Long rank检验进行了分析,并对影响患者预后的相关因素进行了单因素分析和COX比例风险回归分析。结果:96例患者的中位生存时间为30.67个月,其治疗后3、5年总生存率分别为81.25%和71.88%。单因素分析结果显示,血清乳酸脱氢酶(LDH)水平升高(>245 U/L)、国际预后指数(IPI)为3-5分、乙型肝炎病毒(HBV)感染、Ki-67高表达(≥65%)及骨髓浸润的高危难治淋巴瘤患者,其生存率较低(P<0.05)。COX比例风险回归分析结果显示,auto-PBHSCT前未达完全缓解状态和auto-PBHSCT后未行巩固治疗是影响患者预后的危险因素(OR=0.46、0.12,95%CI:0.22-0.95、0.02-0.82,P<0.05)。结论:auto-PBHSCT治疗可明显改善高危难治淋巴瘤患者的生存状况及预后,但auto-PBHSCT治疗后应进行巩固治疗以进一步提高远期生存率、延长生存时间。
Objective: To analyze the factors affecting survival and prognosis of patients with high-risk refractory lymphoma treated with autologous peripheral blood hematopoietic stem cell transplantation( auto-PBHSCT).Methods:A total of 96 cases of high-risk refractory lymphoma received auto-PBHSCT were selected.The total survival rate after the treatment was analyzed by using Kaplan-Meier curve and long rank test,and the prognosis-related factors were analyzed by univariate analysis and COX regression analysis.Results: The median survival time of 96 patients was 30.67 months,and the overall survival rate of 3 and 5 years after treatment was 81.25% and 71.88% respectively.Univariate analysis showed that the patients with high lactate dehydrogenase( LDH) level( 〉245 U/L),3-5 scores of international prognostic index( IPI),hepatitis B virus( HBV) infection,high expression of Ki-67( ≥65%) and bone marrow infiltration had lower survival rate( P〈0.05).COX regression analysis showed that the complete remission wasn't reached before auto-PBHSCT and the consolidation therapy was not carried out after auto-PBHSCT,both of them were the risk factors affecting the prognosis( OR = 0.46,0.12,95% CI: 0.22 - 0.95,0.02 - 0.82,P〈0.05).Conclusion: Auto-PBHSCT in the treatment of patients with high-risk refractory lymphoma can significantly improve the survival status and prognosis,and the consolidotion therapy should be performed after auto-PBHSCT so as to further improve the long-term survival rate and prolong the survival time.
作者
姜丽
朱尊民
JIANG Li;ZHU Zun-Min(Department of Hematology, Henan Provincial People's Hospital, Zhengzhou 410003, Henan Province, China)
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2018年第3期784-788,共5页
Journal of Experimental Hematology