大剂量化疗联合自体造血干细胞移植治疗淋巴瘤的临床疗效观察

Clinical observation of 40 patients with malignant lymphoma treated with high dose chemotherapy combined with autologous hematopoietic stem cell transplantation

目的:观察大剂量化疗联合自体造血干细胞移植(AHSCT)对于淋巴瘤的临床疗效。方法:以2013年3月至2018年2月在安徽省肿瘤医院行AHSCT的40例恶性淋巴瘤患者为研究对象,4例霍奇金淋巴瘤(Hodgkin's lymphoma,HL),36例非霍奇金淋巴瘤(non-Hodgkin's lymphoma,NHL)。采用依托泊苷+G-CSF为外周血干细胞动员方案。预处理方案为BEAM、CBV及BEAC方案。结果:40例患者外周血干细胞采集数量均足够,未出现移植相关死亡。中性粒细胞和血小板植入时间的中位数分别为10 d(7～17 d)和12 d(6～25 d)。随访时间中位数是15个月(1～53个月),无进展生存(PFS)率为72. 5%,总生存(OS)率为(82. 5%)。移植前达完全缓解(CR)的AHSCT患者预后良好;国际预后指数(IPI)评分大于2分的AHSCT患者预后不良。结论:AHSCT对改善恶性淋巴瘤患者的预后有显著的意义。

AIM:To investigate the therapeutic effect of the patients with malignant lymphoma treated with high dose chemotherapy combined with autologous hematopoietic stem cell transplantation(AHSCT).METHODS:The follow up data in 40 patients with malignant lymphoma who recieved AHSCT in Anhui Province Cancer Hospital from March 2013 to February 2018 were analyzed retrospectively.Of the 40 patients,4 were Hodgkin's lymphoma(HL)and 36 were non-Hodgkin's lymphoma(NHL).To mobilize peripheral hematopoietic stem cell,etoposide combined with G-CSF was used.Preconditioning regimens included BEAM,CBV and BEAC.RESULTS:All patients were collected enough peripheral blood stem cells.None of the patients were died for the risks of AHSCT.The median time of the absolute neutrophil count(ANC)implanted was 10(7-17)days.And the median time of platelet count implanted was 12(6-25)days.The median survival time was 15(1-53)months,progression free survival(PFS)was 72.5%,and overall survival(OS)was 82.5%.The patients who achieved CR status before transplantation could have a favorable prognosis.The prognosis in the patients with IPI score>2 was poor.CONCLUSION:AHSCT can improve the prognosis of patients with malignat lymphoma.