中华血液学杂志
中華血液學雜誌
중화혈액학잡지
Chinese Journal of Hematology
2015年
10期
830-834
,共5页
孙婷%胡亮钉%江珉%宁红梅%张斌%任静%李欲航%李勃涛%陈健琳%杨帆%徐晨%王军%楼晓%扈江伟%陈虎
孫婷%鬍亮釘%江珉%寧紅梅%張斌%任靜%李欲航%李勃濤%陳健琳%楊帆%徐晨%王軍%樓曉%扈江偉%陳虎
손정%호량정%강민%저홍매%장빈%임정%리욕항%리발도%진건림%양범%서신%왕군%루효%호강위%진호
淋巴瘤,非霍奇金%复发%难治%造血干细胞移植,异基因%移植预处理
淋巴瘤,非霍奇金%複髮%難治%造血榦細胞移植,異基因%移植預處理
림파류,비곽기금%복발%난치%조혈간세포이식,이기인%이식예처리
Lymphoma,non-Hodgkin%Recurrence%Refractory%Hematopoietic stem cell transplantation%Transplantation conditioning
目的:比较预处理方案Cy-fTBI(环磷酰胺+分次全身照射)与BMM(白消安+马法兰+米托蒽醌)在异基因造血干细胞移植(allo-HSCT)治疗Ⅲ、Ⅳ期非霍奇金淋巴瘤(NHL)疗效上的差异。方法对1998年11月至2014年5月接受allo-HSCT治疗的47例Ⅲ、Ⅳ期NHL病例进行回顾性分析,观察比较Cy-fTBI和BMM预处理方案两组患者移植后造血重建时间、急性移植物抗宿主病(aGVHD)和慢性移植物抗宿主病(cGVHD)累积发生率、移植相关死亡率(TRM)、复发率(RR)、无病生存率(DFS)和总体生存率(OS)。结果移植后中性粒细胞≥0.5×109/L和血小板计数≥50×109/L的中位时间为17(10~72)d和27(5~98)d;aGVHD发生率为53.19%,Ⅰ~Ⅱ度占42.55%,Ⅲ~Ⅳ度占10.64%;cGVHD发生率为21.28%;中位随访9.7(0.2~149.1)个月,47例患者中21例生存。Cy-fTBI组1、3、5年OS率分别为73.5%、49.3%、40.1%,DFS率分别为71.4%、45.6%、39.3%。BMM组1、3、5年OS率分别为67.8%、32.9%、31.4%,DFS率分别为65.3%、31.1%、30.2%。Cy-fTBI组1、3、5年RR率分别为18.9%、19.5%、35.2%,TRM率分别为23.0%、38.3%、39.2%。BMM组1、3、5年RR分别为27.4%、38.9%、39.2%,TRM率分别为24.5%、46.4%、48.2%,两组在OS、DFS、RR、TRM等指标上差异无统计学意义。结论 Allo-HSCT是治疗Ⅲ、Ⅳ期NHL的有效手段,但TRM仍相对较高。Cy-fTBI预处理方案与BMM方案相比,减少了TRM、RR,增加了DFS和OS,但差异无统计学意义。
目的:比較預處理方案Cy-fTBI(環燐酰胺+分次全身照射)與BMM(白消安+馬法蘭+米託蒽醌)在異基因造血榦細胞移植(allo-HSCT)治療Ⅲ、Ⅳ期非霍奇金淋巴瘤(NHL)療效上的差異。方法對1998年11月至2014年5月接受allo-HSCT治療的47例Ⅲ、Ⅳ期NHL病例進行迴顧性分析,觀察比較Cy-fTBI和BMM預處理方案兩組患者移植後造血重建時間、急性移植物抗宿主病(aGVHD)和慢性移植物抗宿主病(cGVHD)纍積髮生率、移植相關死亡率(TRM)、複髮率(RR)、無病生存率(DFS)和總體生存率(OS)。結果移植後中性粒細胞≥0.5×109/L和血小闆計數≥50×109/L的中位時間為17(10~72)d和27(5~98)d;aGVHD髮生率為53.19%,Ⅰ~Ⅱ度佔42.55%,Ⅲ~Ⅳ度佔10.64%;cGVHD髮生率為21.28%;中位隨訪9.7(0.2~149.1)箇月,47例患者中21例生存。Cy-fTBI組1、3、5年OS率分彆為73.5%、49.3%、40.1%,DFS率分彆為71.4%、45.6%、39.3%。BMM組1、3、5年OS率分彆為67.8%、32.9%、31.4%,DFS率分彆為65.3%、31.1%、30.2%。Cy-fTBI組1、3、5年RR率分彆為18.9%、19.5%、35.2%,TRM率分彆為23.0%、38.3%、39.2%。BMM組1、3、5年RR分彆為27.4%、38.9%、39.2%,TRM率分彆為24.5%、46.4%、48.2%,兩組在OS、DFS、RR、TRM等指標上差異無統計學意義。結論 Allo-HSCT是治療Ⅲ、Ⅳ期NHL的有效手段,但TRM仍相對較高。Cy-fTBI預處理方案與BMM方案相比,減少瞭TRM、RR,增加瞭DFS和OS,但差異無統計學意義。
목적:비교예처리방안Cy-fTBI(배린선알+분차전신조사)여BMM(백소안+마법란+미탁은곤)재이기인조혈간세포이식(allo-HSCT)치료Ⅲ、Ⅳ기비곽기금림파류(NHL)료효상적차이。방법대1998년11월지2014년5월접수allo-HSCT치료적47례Ⅲ、Ⅳ기NHL병례진행회고성분석,관찰비교Cy-fTBI화BMM예처리방안량조환자이식후조혈중건시간、급성이식물항숙주병(aGVHD)화만성이식물항숙주병(cGVHD)루적발생솔、이식상관사망솔(TRM)、복발솔(RR)、무병생존솔(DFS)화총체생존솔(OS)。결과이식후중성립세포≥0.5×109/L화혈소판계수≥50×109/L적중위시간위17(10~72)d화27(5~98)d;aGVHD발생솔위53.19%,Ⅰ~Ⅱ도점42.55%,Ⅲ~Ⅳ도점10.64%;cGVHD발생솔위21.28%;중위수방9.7(0.2~149.1)개월,47례환자중21례생존。Cy-fTBI조1、3、5년OS솔분별위73.5%、49.3%、40.1%,DFS솔분별위71.4%、45.6%、39.3%。BMM조1、3、5년OS솔분별위67.8%、32.9%、31.4%,DFS솔분별위65.3%、31.1%、30.2%。Cy-fTBI조1、3、5년RR솔분별위18.9%、19.5%、35.2%,TRM솔분별위23.0%、38.3%、39.2%。BMM조1、3、5년RR분별위27.4%、38.9%、39.2%,TRM솔분별위24.5%、46.4%、48.2%,량조재OS、DFS、RR、TRM등지표상차이무통계학의의。결론 Allo-HSCT시치료Ⅲ、Ⅳ기NHL적유효수단,단TRM잉상대교고。Cy-fTBI예처리방안여BMM방안상비,감소료TRM、RR,증가료DFS화OS,단차이무통계학의의。
Objective To investigate the efficacy of allogeneic hematopoietic stem cell transplantation(allo-HSCT)in the treatment of patients withⅢ,Ⅳnon-Hodgkin lymphoma(NHL), and compared the efficacy between Cy-fractionated to talbody irradiation(fTBI)based conditioning regimen and Maryland, horse flange and mitoxantrone(BMM). Methods The clinical data of 47 patients withⅢ, Ⅳ NHL after allo-HSCT from November 1998 to May 2014 were collected and retrospectively analyzed. To observe the hematopoietic reconstruction recovery after transplantation, cumulative incidence of acute graft- versus- host- disease (aGVHD) and chronic graft- versus- host- disease (cGVHD), transplantation related mortality (TRM), recurrence rate (RR), disease-free survival (DFS), overall survival(OS). Compare the efficacy of fTBI and BMM conditioning regimen at the same time. Results Neutrophils achieving 0.5 × 109/L and platelets achieving 50 × 109/L on day 17 (range, 10-72) post transplantation. Acute GVHD occurred in 53.19%, among them, grade Ⅰ-Ⅱ occurred in 42.55%, gradeⅢ-Ⅳoccurred in 10.65%, and cGVHD occurred in 21.28%. 21 patients were alive with a median follow up of 9.7 months(0.2-149.1 months). Overall survival(OS)was 73.5%, 49.3%, 40.1%respectively in the first, third and fifth year in Cy-fTBI group;in BMM group it was 67.8%, 32.9%and 31.4%respectively, and disease-free survival(DFS)was 65.3%, 45.6%, 30.2%respectively in the first, third and fifth year. In Cy-fTBI group, the recurrence rate(RR)and transplantation related mortality(TRM)in the first year were 18.9%, 23.0% respectively, the third year were 19.5%, 38.3% and the fifth year were 35.2%, 39.2%. In BMM group, RR and TRM in the first year were 27.4%, 24.5% respectively, the third year were 38.9%, 46.4%and the fifth year were 39.2%, 48.2%. However, there was no significant difference in the indicator of OS, DFS, RR, TRM in the two groups. Conclusion Allo-HSCT could make someⅢ,ⅣNHL patients achieve long-term disease-free survival, but the TRM was still high relatively. Moreover, compared with the program of BMM conditioning regimen, Cy-fTBI might reduce the TRM and RR, meanwhile, increase the DFS and OS. However, due to the small number cases of two groups, there was no statistical significant difference.