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目的探讨恶性淋巴瘤患者接受自体外周血造血干细胞移植的疗效及预后因素。方法收集96例恶性淋巴瘤患者病理资料,常规化疗后均接受自体外周血造血干细胞移植。统计患者的基本临床资料、移植前相关指标及预后情况,采用SPSS19.0统计软件对预后情况进行Kaplan-Meier生存分析,应用Cox比例风险模型进行预后因素分析,回顾性的分析总体疗效及预后因素。结果 96例患者中94例顺利完成造血重建,中性粒细胞重建时间为7~19d,平均9d;血小板重建时间10~37d,平均16d;随访时间0~74个月,平均26个月。3年总体生存(OS)率为86.4%,3年无进展生存(PFS)率为70.3%。单因素分析显示IPI评分大于2分、移植前未能达到完全缓解(CR)、乳酸脱氢酶(LDH)高于正常水平、骨髓浸润等为不良预后因素,多因素分析显示移植前状态及LDH水平为独立影响因素。结论大剂量化学治疗联合自体外周血造血干细胞移植是高危难治恶性淋巴瘤安全、有效的治疗方法。移植前能否达到CR、LDH水平为移植疗效的影响因素。
Objective To investigate the efficacy and prognosis of patients with malignant lymphoma receiving autologous peripheral blood stem cell transplantation. Methods The pathological data of 96 patients with malignant lymphoma were collected and received autologous peripheral blood stem cell transplantation after routine chemotherapy. Statistics of patients with basic clinical data, pre-transplant indicators and prognosis, using SPSS19.0 statistical software for Kaplan-Meier survival analysis of prognosis, the use of Cox proportional hazards model for prognostic factor analysis, a retrospective analysis of the overall efficacy and prognostic factors . Results Ninety-four of 96 patients successfully completed hematopoietic reconstitution. The time of neutrophil reconstruction was 7-19 days (mean 9 days). The time of platelet reconstruction was 10- 37 days (mean 16 days). The follow-up time ranged from 0-74 months (average 26 months). 3-year overall survival (OS) rate was 86.4%, 3-year progression-free survival (PFS) rate was 70.3%. Univariate analysis showed that the score of IPI was more than 2, failed to achieve complete remission (CR), the level of lactate dehydrogenase (LDH) was higher than the normal level, the infiltration of bone marrow was the unfavorable prognostic factor. Multivariate analysis showed pre-transplant status and LDH The level of independent factors. Conclusion High-dose chemotherapy combined with autologous peripheral blood stem cell transplantation is a safe and effective treatment for high-risk refractory malignant lymphoma. Whether CR and LDH levels can be achieved before transplantation are the influencing factors for the efficacy of transplantation.