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目的观察自体造血干细胞 (aulologoushematopoiticstemcelltransplantation ,AHSCT)对晚期恶性实体瘤的疗效及副作用。方法 6例患者中 ,1例行自体骨髓移植 (antologousbonemarrowtranspla tion ,ABMT) ,5例行自体外周血干细胞移植 (autologousperipheralbloodstemcelltransplantationAPBSCT)。预处理方案 :乳腺癌为CEP(CTX ,VP-1 6,DDP) ,恶性淋巴瘤为CEA(CTX ,VP-1 6,Ara-c)方案 ,采集的干细胞 1例 4℃保存 ,72小时内回输 ,其余 5例 - 80℃保存。结果APBSCT动员采集单个核细胞数 7 0 2× 1 0 8 kg ,ABMT和APBSCT后 ,患者中性粒细胞计数恢复到 0 5× 1 0 9/L ,血小板达 50× 1 0 9/L以上的时间平均为 1 0 8天和 1 6 2天。毒副作用主要是骨髓抑制和消化道反应 ,随访至今死亡 2例 ,复发 2例 ,2例无瘤生存。结论AHSCT治疗晚期乳腺癌近期疗效肯定 ,可提高生活质量 ,对恶性淋巴瘤的治疗有效 ,但对反复复发患者需移植后作进一步治疗。
Objective To observe the efficacy and side effects of autologous hematopoietic stem cells (aHSCT) on advanced malignant solid tumors. METHODS: Of the 6 patients, 1 received autologous bone marrow transplantation (ABMT) and 5 received autologous peripheral blood stem cell transplantation (APBSCT). Pretreatment program: CEP (CTX, VP-16, DDP) for breast cancer and CEA (CTX, VP-16, Ara-c) for malignant lymphoma. The collected stem cells were preserved at 4°C for 72 hours. Infusion, the remaining 5 cases - 80 °C preservation. Results The number of mononuclear cells mobilized by APBSCT was 720×108 kg. After ABMT and APBSCT, the neutrophils counts of patients returned to 0 5×109/L and platelets reached 50×109/L or more. The average time is 108 days and 162 days. The toxic and side effects were mainly myelosuppression and gastrointestinal reactions. Two patients died in follow-up and 2 patients relapsed. Two patients survived without tumor. Conclusion The short-term curative effect of AHSCT in the treatment of advanced breast cancer is affirmative, which can improve the quality of life and is effective in the treatment of malignant lymphoma. However, patients with recurrent disease should undergo further treatment after transplantation.