大剂量化疗联合自体造血干细胞移植支持治疗实体瘤

THE CLINICAL STUDIED ON HIGH-DOSE CHEMOTHERAPY COMBINED WITH AUTOLOGOUS STEM CELL TRANSPLANTATION IN SOLID TUMOR

目的 研究大剂量化疗结合自体干细胞移植提高化疗的效果。方法 1 9例淋巴瘤、乳腺癌、卵巢癌、多发性骨髓瘤和小细胞肺癌患者 ,有 1 7例接受骨髓干细胞移植 ,2例接受外周血干细胞移植。将干细胞 4℃保存 60～ 72h回输 ,期间给患者进行卡铂 +VP - 1 6+环磷酰胺方案或马法兰 +VP - 1 6 +环磷酰胺方案大剂量化疗。结果 所有病例的骨髓均被摧毁 ,移植后 1 8～ 44h骨髓完全恢复 ,治疗相关病死率为 0。 1 2例移植前为缓解的患者 ,1 1例仍然无病生存 ;7例移植前为复发者 ,均再缓解 ,但再复发 ,生存 1 0～ 2 8个月 ,总生存率 57.89%。结论 大剂量化疗联合自体造血干细胞移植支持治疗可明显提高完全缓解肿瘤患者的治愈率 ;对于复发或难治者 ,可以提高完全缓解率 ,延长生存期 。

Objective To assess the effect of high-dose chemotherapy(HDC) combined with autologous stem cell transplantation (ASCT) in solid tumor. Methods 19 patients with lymphoma,breast cancer,ovarian cancer,multiple myeloma and lung small cell cance were performed HDC+ASCT.HDC consisted of carboplatin,etoposide and cyclophosphamide or melphalan,etoposide and cyclophosphamide. Results Effective rate was 100%.11 patients who accepted ASCT at first complete remission or part remission still alive .7 patients who were relapse or refractory obtained complete remission and relapsed again and died after 10～28 months follow-up.Overall survival rate was 57.89%. Conclusion HDC with ASCT might represent an effective approach for the treatment of some solid patients with chemosensitive disease.Patients who are complete remission or part remission have a obvious survival benefit from HDC.