自体外周血造血干细胞移植治疗非霍奇金淋巴瘤56例临床分析

Autologous peripheral blood hematopoietic stem cell transplantation in 56 patients with non-hodgkin’s lymphoma

摘要:

目的：探讨自体外周血造血干细胞移植（autologous peripheral blood stem cell transplantation，APBSCT）治疗非霍奇金淋巴瘤（non-Hodgkin’s lymphoma，NHL）的临床疗效。方法：回顾性分析2009年2月至2013年10月在我院行APBSCT的NHL患者56例，其中男37例，女19例，中位年龄44岁（16~69）岁，缓解病例46例，部分缓解7例，复发难治3例。结果：56例移植患者中55例获造血重建，1例未造血重建。中性粒细胞绝对值＞0.5×109个/L的中位时间9.5 d （7～18 d）、血小板计数＞20×109个/L的中位时间11.5 d（6~24 d）。24例患者于粒细胞缺乏期时出现发热，5例出现轻中度腹泻，1例出现轻度肝功能损害，1例出现带状疱疹。所有患者随访截止于2014年4月1日，中位随访时间20.25月（3.0~60.5月）。45例存活（其中5例带病生存），10例复发，11例死亡（其中5例死于复发）。复发率为17.9%，总生存率（overall survival，OS）、无病生存率（disease free survival，DFS）分别为80.4%、71.4%。结论：APBSCT是治疗NHL的有效手段，造血重建快，并发症少。

Abstract:

Objective：To study the clinical efficacy of autologous peripheral blood hematopoietic stem cell transplantation（APBSCT） in the treatment of non-Hodgkin’s lymphoma（NHL）. Methods：A total of 56 patients who underwent APBSCT from February 2009 to October 2013 in the hospital were enrolled in the study. There were 37 males and 19 females with a median age of 44 years（16-69 years）；46 cases were in remission，7 cases in partial remission and 3 cases in relapsed or refractory. Results：Among 56 patients treated by APBSCT，55 patients obtained hematopoi－etic reconstitution. The median time for neutrophils recovery（＞0.5×109/L） was 9.5（7-18） d and platelet recovery（＞20×109/L） was 11.5（6-24） d. Twenty-four patients experienced fever during granulocyte lack phase，5 patients experienced mild-to-moderate diarrhea，one patient had mild liver function damage and one patient had herpes zoster. All patients were followed up till the 1st April，2014，and the median follow-up time was 20.25（3-60.5） months. Forty-five cases survived（5 cases alive with disease）；10 cases relapsed；11 cases died（5 cases died of recurrence）. The recurrence rate was 17.9%. Overall survival and disease-free survival were 80.4% and 71.4% respectively. Conclusion：With the advantages of quicker hematopoietic reconstruction and fewer non-Hodgkin’s lymphoma，APBSCT is effective in the treatment of NHL.