自体外周血干细胞支持下CEAC方案治疗非霍杰金淋巴瘤的临床研究

Clinical analysis of CEAC following by autologous peripheral stem cell transplantation in patients with non-Hodgkin′s lymphoma

目的 观察CEAC预处理方案的自体外周血干细胞移植治疗非霍杰金淋巴瘤病人的临床疗效。方法 对 1 0例中、高度恶性非霍杰金淋巴瘤病人进行自体外周血干细胞移植 (APBSCT) ,其中 5例 (5 0 % )病人为Ⅳ期 ,2例病人诊断为中线T细胞淋巴瘤 ,1 0例病人从确诊到移植的中位时间是 4 .5个月 ,以CEAC为预处理方案 :CCNU 0 .2m2 × 1d,Cy 1 .5g/m2 × 4d ,Vp 1 61 0 0mg/m2 × 4d ,Acr C 1 0 0mg/m2 1 2q× 4d。结果 预处理中 1 0例病人均出现Ⅰ～Ⅲ度的消化道反应 ,1例出现Ⅰ度心脏毒性 ,出现Ⅰ、Ⅱ、Ⅲ度肝功能损害各 1例 ,1 0例病人均有Ⅲ度脱发。所有患者移植后造血功能均快速重建 :中性粒细胞计数≥ 0 .5× 1 0 9/L中位时间 1 1 .5d ,血小板计数≥ 2 0× 1 0 9/L的中位时间 1 3d。中位随访时间 1 0 .5个月 (8～ 2 3个月 ) ,8例患者无病存活 ,2例死于疾病复发。结论 CEAC预处理方案的自体外周血干细胞移植治疗非霍杰金氏淋巴瘤病人的耐受性较好 ,毒副作用较轻 ,造血重建快 。

Objective To evaluate the efficacy of CEAC as conditioning regimen of autologous peripheral blood stem cell transplantation(APBSCT)in patients with non Hodgkin′s lymphoma. Methods The study included 10 patients with non Hodgkin′s lymphoma,5 patients (50%) had stage IV disease. The median time from diagnosis to APBSCT was 4.5 months. The CEAC regimens consisted of lomustine (CCNU) 0.2g/m 2,cyclophosphamide (Cy) 6g/m 2,etoposide (E) 400mg/m 2 and cytarabine(Acr C) 800mg/m 2.Results All patients had grade 1 3 gastrointestinal toxicity, 1 patient had grade 1 cardiac toxicity, and 3 patient had hepatic toxicity. All patients were engrafted and hematopoietic reconstitution was rapid: the mean days of ANC recovery were 11.5 days up to 0.5>×10 9/L and PLT 13 days up to >20×10 9/L. With a median follow up of 10.5 months (range 8 23 months), 8 patients were event free survival, 2 patients died due to disease relapse. Conclusion These preliminary results suggest that CEAC can be performed safely. It is efficacious therapeutic measure in the patients with non Hodgkin′s lymphoma..