CAJ | 학술논문

目的　回顾性分析自体外周血干细胞移植(APBSCT)治疗血液恶性病及实体瘤的疗效。方法　51例患血液及实体肿瘤患者接受自体外周血干细胞移植，本文就移植过程中干细胞采集时间、干细胞回输量、骨髓重建时间、移植后各类疾病无病生存期及总体生存期、移植相关并发症、移植后维持化疗等问题进行总结和探讨。结果　(1)与常规化疗相比，自体外周血干细胞移植可延长移植患者的总体生存期及无病生存期，其顺序为NHL>AML>MM>ALL; 3年及5年生存率AML和NHL组分别为74.78%和83.33%,MM组为38.0％和19.0％,ALL组为40.0%和0%。(2)移植后骨髓造血重建时间未用G-CSF组干细胞回输后平均第17.6天外周血白细胞恢复至>0.5×109/L,用G-CSF组平均11.14天。(3)移植相关并发症以发热，肝功能受损和低钾最常见。经治疗上述并发症均可逆转，尚未发现VOD或不可逆性肝损害，无移植相关死亡。移植后随访7年中,共死亡21例，其中20例死于复发，主要为ALL和MM患者。结论　APBSCT已成为治疗血液恶性病及某些实体瘤、改善其预后的重要手段，尤其可明显延长AML及NHL患者的无病生存期及总体生存期。
목적　회고성분석자체외주혈간세포이식(APBSCT)치료혈액악성병급실체류적료효。 방법　51례환혈액급실체종류환자접수자체외주혈간세포이식，본문취이식과정중간세포채집시간、간세포회수량、골수중건시간、이식후각류질병무병생존기급총체생존기、이식상관병발증、이식후유지화료등문제진행총결화탐토。 결과　(1)여상규화료상비，자체외주혈간세포이식가연장이식환자적총체생존기급무병생존기，기순서위NHL>AML>MM>ALL; 3년급5년생존솔AML화NHL조분별위74.78%화83.33%,MM조위38.0％화19.0％,ALL조위40.0%화0%。(2)이식후골수조혈중건시간미용G-CSF조간세포회수후평균제17.6천외주혈백세포회복지>0.5×109/L,용G-CSF조평균11.14천。(3)이식상관병발증이발열，간공능수손화저갑최상견。경치료상술병발증균가역전，상미발현VOD혹불가역성간손해，무이식상관사망。이식후수방7년중,공사망21례， 기중20례사우복발，주요위ALL화MM환자。 결론　APBSCT이성위치료혈액악성병급모사실체류、개선기예후적중요수단，우기가명현연장AML급NHL환자적무병생존기급총체생존기。
Objective　To evaluate the long-term therapeutic effects of autologous peripheral blood stem cell transplantation (auto-PBSCT) on the treatment of hematological and solid tumors. Methods　Fifty-one patients were recruited in this auto-PBSCT study, in which several potentially important parameters were studied including the optimal time for stem cell collection, the dose of stem cell reinfusion, the time of hematopoietic reconstitution, the disease free survival (DFS) and overall survival (OS), complications related to transplantation, and maintenance chemotherapy after auto-PBSCT. Results　After APBSCT, 3-year and 5-year survival rates of NHL were 83.3%; those of AML were 74.7%; those of MM were 37.9% and 19%; those of ALL were 40% and 0% respectively. Hematopoietic reconstitution was greatly promoted by granulocyte colony stimulating factor (G-CSF). The mean time for patients' neutrophil to recover up to >0.5×109/L after APBSCT was 11.14 days in the group of the patients receiving G-CSF in contrast to 17.6 days in the group receiving no G-CSF. The most common complications of transplantation were fever, liver dysfunction and hypokalaemia, which were curable. No death was due to transplantation related complications. Conclusion　Comparing with conventional chemotherapy, our study suggests that auto-PBSCT is a very important therapeutic option that can significantly improve the prognosis in the patients with hematological and solid tumors, especially in the patients with AML and NHL.