自体造血干细胞移植治疗复发难治性B细胞NHL的效果及其影响预后相关因素的分析

Effect of Autologous Hematopoietic Stem Cell Transplantation on Recurrent Refractory B Cell NHL and Its Factors Influencing Prognosis

目的:分析自体造血干细胞移植治疗复发难治性B细胞非霍奇金淋巴瘤(NHL)的效果及其影响预后的相关因素。方法:对同济医院收治的47例复发难治性B细胞NHL患者的临床资料进行回顾性分析。采用Kaplan-Meier法绘制生存曲线,并进行生存分析。采用单因素和多因素分析影响患者预后的相关因素。结果:患者自体造血干细胞移植前完全缓解率仅为51. 06%,移植后完全缓解率为65. 96%。患者中位生存时间为21个月,3年无进展生存率为40. 43%,3年总生存率为48. 94%。单因素分析结果发现,初治时未给予利妥昔单克隆抗体、移植前PET/CT扫描提示未达完全缓解状态均是影响患者预后效果的危险因素(均P <0. 05);多因素分析结果发现,移植前PET/CT扫描提示未达完全缓解状态是影响患者预后效果的危险因素(P <0. 05)。结论:复发难治性B细胞NHL患者应用自体造血干细胞移植治疗可提高临床疗效,并且移植前PET/CT扫描提示未达完全缓解状态对患者预后较为不利。

Objective:To analyze the effect of autologous hematopoietic stem cell transplantation in the treatment of patients with recurrent refractory B cell non-Hodgkin's lymphoma(NHL)and the related factors affecting the prognosis.Methods:The clinical data of 47 cases of recurrent refractory B cell NHLtreated in our hospital were retrospectively analyzed.Survival curves were drawn by Kaplan-Meier,and survival analyses were performed.Univariate and multivariate analyses were used to analyze the prognostic factors.Results:The complete remission rate was 51.06%before autologous hematopoietic stem cell transplantation,but it increased to 65.96%after transplantation.The median survival time was 21 months,the 3 years progression-free survival rate was 40.43%,and the 3 years overall survival rate was 48.94%.The results of unvariate analysis showed that no using the rituximab in the first treatment and incomplete remission shown by PET/CT before transplantation all were the risk factors(P<0.05)affecting the prognosis.By multifactor analysis,it was found that the incomplete mission shown by PET/CT before transplantation was a risk factor for the prognosis(P<0.05).Conclusion:The application of autologous hematopoietic stem cell transplantation for patients with relapsed and refractory B cell NHL can improve the clinical efficacy,and the incomplete remission shown by PET/CTbefore transplantation is more adverse to the patients'prognosis.