CAJ | 학술논문

目的评价自体造血干细胞移植(AHSCT)治疗恶性血液病的疗效。方法用AHSCT治疗白血病及恶性淋巴瘤患者共58例,年龄31.9±10.5(14~58)岁。其中急性非淋巴细胞白血病(ANLL)30例(CR-1 24例,CR2 5例,CR3 1例),急性淋巴细胞白血病(ALL)18例(CR1 13例,CR2 3例,CR3 2例),慢性粒细胞白血病(CML)3例(均获血液学缓解),恶性淋巴瘤7例(CR 4例,PR 3例)。预处理化疗方案选用以下药物中任意两种或三种联合:阿糖胞苷3~4 g/m2,环磷酰胺4~6 g/m2,鬼臼乙叉苷(VP-16)0.5~10 g/m2。除5例联合全身骨髓照射(剂量为7~8 Gy),其余均单用化疗。结果所有患者移植后均重建造血,移植相关死亡1例(1.72%)\.ANLL、ALL CR1期移植者3年无病生存率分别为52.4%±4.2%和46.1%±3.5%,复发率分别为37.7%±4.5%和40.5%±6.7%。10例CML和恶性淋巴瘤患者中,除1例Ⅳ期恶性淋巴瘤患者复发,余均获持续完全缓解。结论为降低白血病和恶性淋巴瘤的复发率,提高患者的无病生存期,无造血干细胞供者的CR1期白血病及恶性淋巴瘤患者应积极行AHSCT。
목적평개자체조혈간세포이식(AHSCT)치료악성혈액병적료효。방법용AHSCT치료백혈병급악성림파류환자공58례,년령31.9±10.5(14~58)세。기중급성비림파세포백혈병(ANLL)30례(CR-1 24례,CR2 5례,CR3 1례),급성림파세포백혈병(ALL)18례(CR1 13례,CR2 3례,CR3 2례),만성립세포백혈병(CML)3례(균획혈액학완해),악성림파류7례(CR 4례,PR 3례)。예처이화료방안선용이하약물중임의량충혹삼충연합:아당포감3~4 g/m2,배린선알4~6 g/m2,귀구을차감(VP-16)0.5~10 g/m2。제5례연합전신골수조사(제량위7~8 Gy),기여균단용화료。결과소유환자이식후균중건조혈,이식상관사망1례(1.72%)\.ANLL、ALL CR1기이식자3년무병생존솔분별위52.4%±4.2%화46.1%±3.5%,복발솔분별위37.7%±4.5%화40.5%±6.7%。10례CML화악성림파류환자중,제1례Ⅳ기악성림파류환자복발,여균획지속완전완해。결론위강저백혈병화악성림파류적복발솔,제고환자적무병생존기,무조혈간세포공자적CR1기백혈병급악성림파류환자응적겁행AHSCT。
Objective To evaluate the therapeutic effect of autologous hematopoietic stem cell transplantation(AHSCT) on malignant hematopathy.Methods From December of 1989 to November of 1999, 58 patients with median age of 31.9±10.5 (14~58) years received AHSCT, 30 of them were acute non-lymphoblastic leukemia(ANLL)(CR1 24, CR2 5, CR3 1), 18 were acute lymphoblastic leukemia(ALL)(CR1 13, CR2 3, CR3 2), 3 were chronic myelogenous leukemia(CML,all acquired hemato logically complete remission ) and 7 were malignant lymphoma(4 of CR, 3 of PR). 2 or 3 of following agents: Ara-C 3~4 g/m2, CTX 4~6 g/m2 and VP-16 0.5~1.0 g/m2, were combined as conditioning regimen in all patients. Among them 5 patients accepted additional total body bone marrow irradiation.Results All the patients have reconstituted bone marrow hematopoiesis after transplantation. The transplantation-related mortality rate was 1.72％(one case). The 3-year disease-free survival rates of ANLL and ALL at CR1 stage were 52.4%±4.2％ and 46.1%±3.5％ respectively, and the relapse rate were 37.7%±4.5％ and 40.5%±4.6％ respectively. Among 10 patients with CML and malignant lymphoma, 9 achieved continuous complete remission(CCR) except that one case of Ⅳ stage lymphoma relapsed.Conclusion Without compatible donors, patients with leukemia and malignant lymphoma at CR1 stage could receive AHSCT to reduce relapse and increase disease-free survival.