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【目的】分析自体外周血造血干细胞移植(autologous peripheral blood stem cell transplantation,APB-SCT)治疗恶性淋巴瘤的临床疗效及安全性。【方法】采用APBSCT联合大剂量化疗治疗恶性淋巴瘤31例。平均4周期常规诱导化疗后行APBSC动员及采集。动员方案:非霍奇金淋巴瘤(NHL)患者采用常规剂量CHOP方案,其中环磷酰胺(CTX)增至2.5 g/m2;霍奇金淋巴瘤(HD)患者采用高剂量单药CTX 4 g/m2。化疗后给予粒细胞集落刺激因子(G-CSF)3.5~5μg/kg。当外周血白细胞(WBC)计数达(2~5)×109/L,单核细胞(MNC)计数达20%~30%时分离外周血造血干细胞。预处理方案:异环磷酰胺(IFO)12 g/m2或CTX 4 g/m2,阿糖胞苷(Ara-c)4.5 g/m2,足叶乙甙(Vp-16)0.75 g/m2。移植后对原发灶直径大于4 cm或有肿瘤残留的病灶给予局部补量放疗。【结果】31例患者移植后缓解时间为1~108个月,中位缓解期43个月。其中1年无病生存26例(83.9%),2年23例(74.1%),3年21例(67.7%)。最长存活108个月。全组无移植相关死亡。【结论】APB-SCT联合大剂量化疗治疗恶性淋巴瘤的疗效明显优于常规化疗且安全性高值得推广。
【Objective】 To analyze the clinical efficacy and safety of autologous peripheral blood stem cell transplantation (APB-SCT) in the treatment of malignant lymphoma. 【Methods】 Thirty-one cases of malignant lymphoma were treated with APBSCT and high-dose chemotherapy. The average 4-week routine induction chemotherapy APBSC mobilization and acquisition. Mobilization regimen: Patients with non-Hodgkin’s lymphoma (NHL) received routine dose of CHOP regimen with CTX increased to 2.5 g / m 2; patients with Hodgkin’s lymphoma (HD) received high-dose CTX 4 g / m2. After chemotherapy granulocyte colony stimulating factor (G-CSF) 3.5 ~ 5μg / kg. When peripheral blood leukocytes (WBC) count up to (2 ~ 5) × 109 / L, mononuclear cells (MNC) count up to 20% to 30% of peripheral blood stem cells. Pretreatment regimen: IFG 12 g / m2 or CTX 4 g / m2, Ara-c 4.5 g / m2 and Vp-16 0.75 g / m2. After transplantation, the primary lesion diameter greater than 4 cm or residual tumor lesions given local dose of radiotherapy. 【Results】 The remission time of 31 patients after transplantation was 1 ~ 108 months, and the median remission was 43 months. Among them, 26 cases (83.9%) survived 1 year without disease, 23 cases (74.1%) in 2 years and 21 cases (67.7%) in 3 years. The longest survival of 108 months. The whole group without transplant-related deaths. 【Conclusion】 APB-SCT combined with high-dose chemotherapy in the treatment of malignant lymphoma is obviously superior to conventional chemotherapy and has high safety.