自体外周血干细胞移植治疗血液恶性病及实体瘤

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目的 回顾性分析自体外周血干细胞移植(APBSCT)治疗血液恶性病及实体瘤的疗效。方法 51例患血液及实体肿瘤患者接受自体外周血干细胞移植,本文就移植过程中干细胞采集时间、干细胞回输量、骨髓重建时间、移植后各类疾病无病生存期及总体生存期、移植相关并发症、移植后维持化疗等问题进行总结和探讨。结果 (1)与常规化疗相比,自体外周血干细胞移植可延长移植患者的总体生存期及无病生存期,其顺序为NHL>AML>MM>ALL; 3年及5年生存率AML和NHL组分别为74.78%和83.33%,MM组为38.0%和19.0%,ALL组为40.0%和0%。(2)移植后骨髓造血重建时间未用G-CSF组干细胞回输后平均第17.6天外周血白细胞恢复至>0.5×109/L,用G-CSF组平均11.14天。(3)移植相关并发症以发热,肝功能受损和低钾最常见。经治疗上述并发症均可逆转,尚未发现VOD或不可逆性肝损害,无移植相关死亡。移植后随访7年中,共死亡21例, 其中20例死于复发,主要为ALL和MM患者。结论 APBSCT已成为治疗血液恶性病及某些实体瘤、改善其预后的重要手段,尤其可明显延长AML及NHL患者的无病生存期及总体生存期。
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