CAJ | 학술논문

目的探讨自体外周血造血干细胞移植支持下大剂量化疗治疗复发弥漫大 B 细胞淋巴瘤的疗效及安全性.方法选择2000年1月至2011年12月在我科住院治疗的复发弥漫性大 B 细胞淋巴瘤患者72例,根据治疗方式随机分为移植组和常规化疗组,每组各36例.移植组患者实施移植前予以 ICE 方案化疗4~6个周期,行自体外周血造血干细胞移植后,未达到完全缓解的给予放疗;而常规化疗组仅给予 ICE 方案化疗4~6个周期,未达到完全缓解的给予放疗.治疗后比较两组的临床疗效和不良反应的发生情况.结果移植组患者完全缓解33例(91.7%),部分缓解3例(8.3%),常规化疗组患者完全缓解23例(63.9%),部分缓解13例(36.1%),两组临床疗效的差异有统计学意义(P<0.05).移植组Ⅳ度骨髓抑制的发生率显著高于常规化疗组(P<0.05),而两组胃肠道反应发生率的差异无统计学意义(P>0.05).移植组和常规化疗组的5年总生存率(OS)分别为56%和38%,5年无病生存率(DFS)分别是43%和20%,差异均有统计学意义(P<0.05).结论自体外周血干细胞移植支持下大剂量化疗治疗复发弥漫大 B 细胞淋巴瘤疗效较单纯化疗更好,且不良反应患者可耐受.
목적탐토자체외주혈조혈간세포이식지지하대제양화료치료복발미만대 B 세포림파류적료효급안전성.방법선택2000년1월지2011년12월재아과주원치료적복발미만성대 B 세포림파류환자72례,근거치료방식수궤분위이식조화상규화료조,매조각36례.이식조환자실시이식전여이 ICE 방안화료4~6개주기,행자체외주혈조혈간세포이식후,미체도완전완해적급여방료;이상규화료조부급여 ICE 방안화료4~6개주기,미체도완전완해적급여방료.치료후비교량조적림상료효화불량반응적발생정황.결과이식조환자완전완해33례(91.7%),부분완해3례(8.3%),상규화료조환자완전완해23례(63.9%),부분완해13례(36.1%),량조림상료효적차이유통계학의의(P<0.05).이식조Ⅳ도골수억제적발생솔현저고우상규화료조(P<0.05),이량조위장도반응발생솔적차이무통계학의의(P>0.05).이식조화상규화료조적5년총생존솔(OS)분별위56%화38%,5년무병생존솔(DFS)분별시43%화20%,차이균유통계학의의(P<0.05).결론자체외주혈간세포이식지지하대제양화료치료복발미만대 B 세포림파류료효교단순화료경호,차불량반응환자가내수.
@@@@Objective To approach the therapeutic effect and reliability of high dose therapy supported by autologous stem cell transplantation for recurrence diffuse large B-cell lymphoma. Methods 72 patients with recurrence diffuse large B-cell lym-phoma who hospitalized in our department during January 2000 and December 2011 were divided randomly into transplantation group and routine-chemotherapy group according to the ways of therapy and each group included 36 patients. Patients in trans-plantation group were administrated with ICE schedule for 4-6 periods before autologous peripheral blood stem cell transplan-tation, and received radiotherapy if they didn’t get complete remission after transplantation. Patients in routine-chemotherapy group were only administrated with ICE schedule for 4-6 periods, and were offered with radiotherapy if no complete remission. Therapeutic effect and adverse reaction was observed and compared after treatment. Results In transplantation group, there were 33 cases (91.7%) of complete remission, and 3 cases (8.3%) of partial remission. While in the routine-chemotherapy group, there were 23 cases (63.9%) of complete remission, and 13 cases (36.1%) of partial remission. There was significant statistical difference in curative effect between the two groups (P<0.05). The incidence of Ⅳ degree bone marrow depression in transplantation group was apparently higher than that of routine-chemotherapy group (P<0.05), but no statistical difference was found in incidence of gastrointestinal tract reaction between two groups. 5-year OS was respectively 56% and 38% in transplantation group and rou-tine-chemotherapy group, and 5-year DFS was respectively 43% and 20% , both with statistically significant difference (P<0.05).Conclusion The therapeutic effect of high dose therapy supported by autologous stem cell transplantation for recurrence dif-fuse large B-cell lymphoma was much better than that of routine-chemotherapy, and adverse reaction was tolerant.