非霍奇金淋巴瘤采用BEAM方案预处理行自体外周血干细胞移植治疗的临床分析

Clinical analysis of BEAM regimen pretreatment for autologous peripheral blood stem cell transplantation in treatment of non-Hodgkin's lymphoma

目的探讨非霍奇金淋巴瘤采用BEAM方案预处理行自体外周血造血干细胞移植治疗的临床疗效和安全性。方法回顾性分析2016年1月至2019年6月福建省立医院血液科收治的28例非霍奇金淋巴瘤患者接受自体外周血造血干细胞移植,选用经典BEAM预处理方案:卡莫司汀300 mg/m^(2)(-6 d),依托泊苷200 mg/m^(2)[(-5 d)~(-2 d)],阿糖胞苷400 mg/m^(2)[(-5 d)~(-2 d)],马法兰140 mg/m^(2)(-1 d)。结果所有患者在移植后骨髓造血均获得重建,移植后达到外周血中性粒细胞绝对计数(ANC)≥0.5×10^(9)/L及血小板≥20×10^(9)/L的中位时间分别为12.0(9~22)d和15.5(10~28)d。主要不良反应为骨髓抑制、感染、腹泻、口腔黏膜炎、植入综合征。中位随访时间35.4(6~92)个月,中位生存时间28.5(11~84)个月,预计2年总生存率(OS)为84.3%,2年无病生存率(DFS)为83.6%。结论BEAM方案预处理行自体外周血造血干细胞移植治疗非霍奇金淋巴瘤疗效肯定,造血重建快、安全、低毒。

Objective To explore the clinical efficacy and safety of BEAM regimen pretreatment for autologous peripheral blood stem cell transplantation in the treatment of non-Hodgkin's lymphoma.Methods A retrospective analysis of 28 patients with non-Hodgkin's lymphoma received autologous peripheral blood stem cell transplantation in the Department of Hematology of Fujian Provincial Hospital from January 2016 to June 2019 was conducted.The classic BEAM pretreatment regimen was used:Carmustine 300 mg/m^(2)(-6 d),etoposide 200 mg/m^(2)[(-5 d)-(-2 d)],cytarabine 400 mg/m^(2)[(-5 d)-(-2 d)],and melphalan 140 mg/m^(2)(-1 d).Results The bone marrow hematopoiesis was reconstructed in all patients after transplantation.After transplantation,the median time to achieve absolute peripheral blood neutrophil count(ANC)≥0.5×10^(9)/L and platelet≥20×10^(9)/L was 12.0(9-22)d and 15.5(10-28)d,respectively.The main adverse events were bone marrow suppression,infection,diarrhea,oral mucositis and implantation syndrome.The median follow-up time was 35.4(6-92)months,and the median survival time was 28.5(11-84)months.The estimated 2-year overall survival(OS)was 84.3%,and the 2-year disease-free survival(DFS)was 83.6%.Conclusion BEAM regimen pretreatment for autologous peripheral blood stem cell transplantation has positive effect in the treatment of non-Hodgkin's lymphoma,with rapid hematopoietic reconstitution,high safety and low toxicity.