摘要
高危神经母细胞瘤(neuroblastoma,NB)恶性程度高且预后差,需要综合治疗。造血干细胞移植(hematopoietic stem cell transplantation,HSCT)是诱导缓解后巩固治疗中的重要组成部分,目前以自体造血干细胞移植(autologous HSCT,AHSCT)为主,取得较好的客观缓解,也有复发/难治性患儿接受异基因造血干细胞移植(allogeneic HSCT,allo-HSCT)。作为超大剂量化疗下的支持治疗,双次HSCT比单次HSCT更能改善患儿无事件生存。HSCT预处理方案以白消安/马法兰(Bu/Mel)和卡铂/依托泊苷/马法兰(CEM)为主。Bu/Mel在无事件生存率上优于CEM方案。尽管免疫治疗明显改善了高危患儿的生存期,但是HSCT目前仍在一线综合治疗中处于重要地位。本文拟就HSCT在NB中的应用进行综述。
High-risk neuroblastoma(HRNBL)is an aggressive solid tumor with a poor prognosis.Treatment is based on multidisciplinary collaboration.Hematopoietic stem cell transplantation(HSCT)plays an important role in the consolidation phase.Autologous stem cell transplantation is frequently used in clinical practice.Some relapsed/refractory patients achieve a good response through the use of allogeneic HSCT(allo-HSCT).Tandem transplantation results in a significantly better event-free survival(EFS)than single transplantation.Conditioning regimens include busulfan/melphalan(Bu/Mel)and carboplatin/etoposide/melphalan(CEM)for advanced-stage neuroblastoma.Bu/Mel is associated with better EFS than CEM.HSCT is the standard of care in the treatment of HRNBL,although immunotherapy has significantly improved survival.This article reviews the use of HSCT in neuroblastoma.
作者
朱佳
张翼鷟
Jia Zhu;Yizhuo Zhang(Collaborative Innovation Center for Cancer Medicine,State Key Laboratory of Oncology in South China,Guangzhou 510060,China;Department of Pediatric Oncology,Sun Yat-sen University Cancer Center,Guangzhou 510060,China)
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2023年第9期453-457,共5页
Chinese Journal of Clinical Oncology
基金
国家重点研发计划项目(编号:2022YFC2705005)资助。
关键词
神经母细胞瘤
高危
造血干细胞移植
预处理方案
neuroblastoma(NB)
high-risk
hematopoietic stem cell transplantation(HSCT)
conditioning regimen