白血病·淋巴瘤
白血病·淋巴瘤
백혈병·림파류
JOURNAL OF LEUKEMIA & LYMPHOMA
2010年
12期
728-731
,共4页
彭捷%徐雅靖%傅敢%刘弋%陈焱%祝焱%何群%刘巍%吴登蜀%赵谢兰%钟美佐%陈方平
彭捷%徐雅靖%傅敢%劉弋%陳焱%祝焱%何群%劉巍%吳登蜀%趙謝蘭%鐘美佐%陳方平
팽첩%서아정%부감%류익%진염%축염%하군%류외%오등촉%조사란%종미좌%진방평
造血干细胞移植%血液肿瘤%并发症%无病生存率
造血榦細胞移植%血液腫瘤%併髮癥%無病生存率
조혈간세포이식%혈액종류%병발증%무병생존솔
Hemopoietic stem cell transplantation%Hematologic neoplasms%Complications%Disease free survival
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 中南大学湘雅医院1994年4月至2008年8月对61例恶性血液病患者进行了61次AHSCT治疗,移植时急性非淋巴细胞白血病(ANLL)30例,非霍奇金淋巴瘤(NHL)25例,霍奇金淋巴瘤(HL)3例,浆细胞瘤3例.ANLL采用预处理为MAC方案:美法仑(Mel)160mg/m2×1次,阿糖胞苷(Ara-C)2.0 g或2.5 g×2次,环磷酰胺(Cy)1.8 g/m2×2次;淋巴瘤以及浆细胞瘤采用预处理方案:全身照射(TBI)+Cy,单次照射8～10 Gy,剂量率5 cGy/min,Cy 1.8 g/m2×2次.或在以上方案基础上进行修改.结果 所有患者造血重建,1例患者移植过程中心脏衰竭死亡,移植相关死亡率为1.6%.60例患者长期随访,1例失访.移植组中位随访期为52(2～211)个月,复发13例(21.3%),复发中位时间为18(2～77)个月.死亡14例(23.0%),现生存47例(77.0%),中位生存时间为66(15～211)个月.5年无病生存(DFS)率为(77.5±5.5)%,比同期单纯接受化疗者的(31.6±7.3)%明显增高,差异有统计学意义(P＜0.01).结论 AHSCT移植患者移植相关死亡率低,无病生存率较高,可作为恶性血液病治疗的重要方法.
目的 評價自體造血榦細胞移植(AHSCT)治療噁性血液病的療效.方法 中南大學湘雅醫院1994年4月至2008年8月對61例噁性血液病患者進行瞭61次AHSCT治療,移植時急性非淋巴細胞白血病(ANLL)30例,非霍奇金淋巴瘤(NHL)25例,霍奇金淋巴瘤(HL)3例,漿細胞瘤3例.ANLL採用預處理為MAC方案:美法崙(Mel)160mg/m2×1次,阿糖胞苷(Ara-C)2.0 g或2.5 g×2次,環燐酰胺(Cy)1.8 g/m2×2次;淋巴瘤以及漿細胞瘤採用預處理方案:全身照射(TBI)+Cy,單次照射8～10 Gy,劑量率5 cGy/min,Cy 1.8 g/m2×2次.或在以上方案基礎上進行脩改.結果 所有患者造血重建,1例患者移植過程中心髒衰竭死亡,移植相關死亡率為1.6%.60例患者長期隨訪,1例失訪.移植組中位隨訪期為52(2～211)箇月,複髮13例(21.3%),複髮中位時間為18(2～77)箇月.死亡14例(23.0%),現生存47例(77.0%),中位生存時間為66(15～211)箇月.5年無病生存(DFS)率為(77.5±5.5)%,比同期單純接受化療者的(31.6±7.3)%明顯增高,差異有統計學意義(P＜0.01).結論 AHSCT移植患者移植相關死亡率低,無病生存率較高,可作為噁性血液病治療的重要方法.
목적 평개자체조혈간세포이식(AHSCT)치료악성혈액병적료효.방법 중남대학상아의원1994년4월지2008년8월대61례악성혈액병환자진행료61차AHSCT치료,이식시급성비림파세포백혈병(ANLL)30례,비곽기금림파류(NHL)25례,곽기금림파류(HL)3례,장세포류3례.ANLL채용예처리위MAC방안:미법륜(Mel)160mg/m2×1차,아당포감(Ara-C)2.0 g혹2.5 g×2차,배린선알(Cy)1.8 g/m2×2차;림파류이급장세포류채용예처리방안:전신조사(TBI)+Cy,단차조사8～10 Gy,제량솔5 cGy/min,Cy 1.8 g/m2×2차.혹재이상방안기출상진행수개.결과 소유환자조혈중건,1례환자이식과정중심장쇠갈사망,이식상관사망솔위1.6%.60례환자장기수방,1례실방.이식조중위수방기위52(2～211)개월,복발13례(21.3%),복발중위시간위18(2～77)개월.사망14례(23.0%),현생존47례(77.0%),중위생존시간위66(15～211)개월.5년무병생존(DFS)솔위(77.5±5.5)%,비동기단순접수화료자적(31.6±7.3)%명현증고,차이유통계학의의(P＜0.01).결론 AHSCT이식환자이식상관사망솔저,무병생존솔교고,가작위악성혈액병치료적중요방법.
Objective To evaluate the clinical outcome of autologous hemopoietic stem cell transplantation (AHSCT) for hematological malignancies. Methods Data of 61 patients with hematological malignancies who underwent AHSCT in Xiangya Hospital from April 1994 to August 2008 were retrospectively analyzed. There were 30 acute non-lymphoblastic leukemias (ANLL), 25 non-Hodgkin lymphoma (NHL), 3 Hodgkin lymphoma (HL), and 3 plasmacytoma. Mel 160 mg/m2 + Ara-C 2.0/2.5 g × 2 +Cy 1.8 g/m2 × 2, or TBI 8-10 Gy + Cy 1.8 g/m2 × 2 were mainly included in pretreatment regimens. Results All patients had rapid hemopoietic reconstitution. There was one patient who died of heart failure during the transplantation process. The rate of AHSCT related death was 1.6 %. The median follow up duration was 52(2-211) months. Forty-seven of 61 patients were still alive during the analysis. The probabilities of disease free survival (DFS) at 5 years were significantly different between these two groups: (77.5±5.5) % for AHSCT groups and (31.6±7.3) % for synchronous intensive chemotherapy groups(P ＜0.01). Conclusion AHSCT can be safely performed as an important treatment constituent for hematological malignancies.
