自体外周血干细胞移植治疗高危恶性实体瘤

Treatment of high risk solid tumor using autologous peripheral blood stem cell transplantation

目的 :探讨自体外周血干细胞移植治疗高危恶性实体瘤的可行性及疗效并了解干细胞动员、采集时机、骨髓恢复时间等问题。方法 :16例经病理确诊的高危乳腺癌、淋巴瘤及小细胞肺癌等在经不同程度的化疗后 ,进行了大剂量化疗并自体外周血干细胞的移植。结果 :全部病人均获造血重建 ,中性粒细胞 (>0 .5× 10 9·L-1)造血重建中位时间 14 (10～ 2 1)d ,血小板 (>2 0× 10 9·L-1)造血重建中位时间约 16 (12～ 2 5 )d。本组中 10例 (6 2 .5 % )病人随访中位时间 4 8月 (2～ 84月 )无病存活 ,6 (37.5 % )例复发。结论 :大剂量化疗并自体外周血干细胞移植治疗高危恶性实体瘤疗效好 ,且较安全 ,而骨髓恢复的快慢似和回输的单个核细胞的量有关 ,和年龄无关。

Objective:To study the possibility and efficacy of high dose chemotherapy with autologous peripheral blood stem cell transplantation in the treatment of high risk solid tumors, and the issues of stem cell mobilization,harvest and engraftment. Methods:16 patients with pathologically confirmed high risk breast cancer, lymphoma,and small cell lung cancer, previously treated with combination chemotherapy, were treated with high dose chemotherapy with autologous peripheral blood stem cell transplantation.Results:All the engrafted patients gained hematopoietic reconstitution, the median engraftment time for absolute neutrophil (>0.5×10 9·L -1) was day 14(10～21) and the time for platelet (>20×10 9.L -1) was day 16(12～25). 10 patients (62.5%) were disease-free survivals for median 48 (2-84) months follow-up, 6 of all (37.5%) had developed relapse. Conclusion:Treatment of high risk solid tumor with high dose chemotherapy supported by autologous peripheral blood stem cell transplantation are both effective and safe. The time to hematopoietic engraftment has some relation with the number of infused mononuclear cells,but not with the patient's age.