自体外周血干细胞移植治疗血液肿瘤56例疗效分析

Analysis of therapeutic effects of autologous peripheral blood stem cell transplantation for treatment of 56 patients with hematologic malignancies

目的 评价自体外周血干细胞移植 (APBSCT)治疗血液肿瘤的疗效。方法 自 2 0 0 1年 3月～ 2 0 0 3年 5月 ,以APB SCT治疗血液肿瘤患者共 5 6例 ,年龄 2～ 5 9岁 (中位年龄 2 5岁 ) ;其中 ,急性淋巴细胞白血病 (ALL) 1 7例 ,急性髓细胞白血病(AML) 3例 ,非霍杰金淋巴瘤 (NHL) 30例 ,霍杰金淋巴瘤 (HD) 4例 ,多发性骨髓瘤 (MM) 2例。动员方案为 :联合化疗 +G CSF。预处理方案 :包括含TBI(2 4例 )与不含TBI的高剂量化疗方案 (32例 )。结果 所有患者移植后造血功能均快速重建。 1 2例患者于移植后 2～ 1 3个月分别死于感染和疾病进展。其余患者已无病存活 2～ 2 6个月。ALL首次完全缓解 (ALL CR1 )的 1 1例患者中 9例存活 (即ALL CR1 9/ 1 1 ) ,再次完全缓解 (ALL CR2 )的 6例患者中 3例存活 (即ALL CR2 3/ 6 )。其他血液肿瘤患者存活情况分别为 :AML CR1 1 / 2 ,AML CR2 0 / 1 ;NHL CR1 2 0 / 2 1 ,NHL CR2 3/ 5 ,NHL NR 2 / 4 ;HD 4 / 4 ;MM 2 / 2。结论 APBSCT是血液肿瘤安全有效的治疗方法 ,对首次治疗获得完全缓解的NHL(NHL CR1 )疗效最好 ,可显著改善初次完全缓解的ALL(ALL CR1 )

Objective To evaluate effect of autologous peripheral blood stem cell transplantation (APBSCT) on the treatment of hematologic malignancies. Methods fifty six patients with hematologic malignancies were included from April 2001 to May 2003. Their ages ranged from 2 to 59 years (median 26). There were 17 acute lymphocytic leukemia (ALL),3 acute myelogenous leukemia (AML),30 non Hodgkin′s lymphoma (NHL),4 Hodgkin′s lymphoma (HD)and 2 multipl myeloma (MM)respectively. Combined chemotherapy regimen followed by G CSF was used for PBSC mobilization. Conditioning regimens were composed high dose chemotherapy (HDC)with total body irradiation (TBI)(24 cases) or without TBI(32 cases).Results All patients were engrafted and hematopoietic reconstitution was rapid. Of the patients, twelve died from infection or desease relapse two to thirteen months post transplantation, and other patients were disease free survival (EFS)for two to twenty six months. There were nine survival in eleven ALL CR1 patients,i.g. 9/11 in ALL CR1,and 3/6 in ALL CR2,1/2 in AML CR1,0/1 in AML CR2,20/21 in NHL CR1,3/5 in NHL CR2,2/4 in NHL NR,4/4 in HD,2/4 in MM,respectively. Conclusion Our study suggests that APBSCT is a very important therapeutic option that can significantly improve the prognosis in the hematologic malignancies, especially in NHL patients of CR1 and ALL patients of CR1.