摘要
目的 观察自体造血干细胞移植 (AHSCT)对难治性恶性淋巴瘤的疗效及不良反应。方法 4例对CHOP方案为主化疗反应不良的恶性淋巴瘤 ,以HD -VCCA方案化疗加TLI预处理的自体外周血干细胞移植 (APBSCT)治疗。自体骨髓移植 (ABMT)两例 ,CTX加VP 16联合rhG CSF动员外周血干细胞的APBSCT者两例。干细胞 4℃保存 ,72h内回输。结果 4例移植期间中性粒细胞计数恢复到≥ 0 .5× 10 9/L的时间 ,血小板达≥ 5 0× 10 9/L的时间和网织红细胞比例达≥ 0 .5 %的时间 ,APBSCT和ABMT分别平均为 +9.5d和 +11d ;+14d和 +2 1.5d ;+9d和 16 .5d。不良反应主要为消化道反应 ,移植后血清卵泡刺激素 (FSH)和黄体生成素 (LH)水平升高 ,雌二醇 (E2 )水平降低的继发性闭经 2例。 4例已无病生存 8～ 5 7个月。结论 干细胞不冷冻的AHSCT治疗难治性恶性淋巴瘤安全、简便、有效。APBSCT较ABMT造血功能恢复快 ,不良反应小。预处理对性腺有损伤。
Objective To observe the effectiveness and side effects of autologous hematopoietic stem cell transplantation (AHSCT) for refractory malignant lymphoma (ML). Methods Four cases of ML refractory to treatment of cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP), received AHSCT with conditioning regimen consisted of high dose Vincristine, Me CCNU, Cyclophosphamide and Ara C (HD VCCA) and total lymphatic tissue irradiation (TLI). Two received ABMT and two received APBSCT with CTX, VP16 and rhG CSF for APBSC mobilization. The stem cell harvest was stored at 4℃ without purgation after collection and retransfused to patients within 72 hours. Results All patients engrafted successfully. The patients' granulocyte count ≥0.5×10 9/L on day +9.5 and +11, the platelet count ≥50×10 9/L on day +14 and +21.5, the reticulocyte reached ≥0.5% on day +9 and 16.5 after APBSCT and ABMT, respectively. The side effects of AHSCT were mainly the gastrointestinal and two women developed secondary amenorrhea with serum follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels increased but estradiol (E 2) levels decreased after AHSCT. Up to now, These four patients had survived disease free for 8～57 months. Conclusion There are earlier recovery of hematopoietic function and fewer complication in APBSCT than in ABMT. AHSCT without cryopreservation is safe, convenient and efficient, but with some gonadal damage.(Shanghai Med J, 2000,23∶282 285)
出处
《上海医学》
CAS
CSCD
北大核心
2000年第5期282-285,共4页
Shanghai Medical Journal
关键词
自体造血干细胞移植
治疗
恶性淋巴瘤
Hematopoietic stem cell transplantation, Autologous
Bone marrow transplantation
Peripheral blood stem cell
Malignent lymphoma, refractory
