自体外周血干细胞移植治疗恶性血液病临床疗效观察

目的　对４９ 例自体外周血干细胞移植（ＡＰＢＳＣＴ） 治疗的恶性血液病患者有关材料进行总结分析。方法　ＡＰＢＳＣＴ治疗恶性血液病患者４９ 例，计５１ 例次，其中急性髓系白血病（ＡＭＬ）１８ 例，急性淋巴细胞白血病（ＡＬＬ）１０ 例，多发性骨髓瘤（ＭＭ）１４ 例（ 其中２ 例行２ 次移植） ，非霍奇金淋巴瘤（ＮＨＬ）６ 例，骨髓增生异常综合征ＲＡＥＢｔ１ 例。结果　与常规化疗相比，ＡＰＢＳＣＴ可延长移植患者的无病生存期及总生存期，３ 年及５ 年生存率在ＡＭＬ、ＮＨＬ组分别为７４．７８％ 和８３．３３％ ，ＭＭ 组为３８ ．００ ％ 和１９ ．００ ％ ，ＡＬＬ组为４０ ．００ ％ 和０ 。移植后造血重建时间，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。４９ 例患者移植相关死亡率为零，至今随访７ 年，死亡２１ 例，其中２０ 例死于复发，主要为ＡＬＬ和ＭＭ 患者。移植相关并发症以发热、肝功能受损和低钾最常见，经治疗可好转。结论　ＡＰＢＳＣＴ是治疗血液系统肿瘤，改善其预后的重要手段之一。

An analysis of autologous peripheral stem cell transplantation for hematological malignancies

OBJECTIVE: To summarize the data of autologous peripheral stem cell transplantation (APBSCT) for 49 hematological malignancies patients. METHODS: Forty-nine patients, 18 with acute myeloid leukemia, (AML) 10 acute lymphoblastic leukemia(ALL), 14 multiple myeloma(MM), 6 non-Hodgkin's lymphoma(NHL) and 1 myelodysplastic syndrome(MDS RAEB-t) received APBSCT were retrospectively analyzed. RESULTS: Comparing to conventional chemotherapy, APBSCT can prolong the patients' disease-free survival(DFS) and overall survival (OS). The 3 and 5-year OS rates were 74.78% and 83.33% for AML/NHL; 38% and 19% for MM; 40% and 0 for ALL, respectively. The time of hematopoietic reconstitution was influenced by G-CSF administration significantly. The mean time of neutrophil recovering to 0.5 x 10(9)/L after APBSCT was +17.7 days in no G-CSF group, and +11.14 days in G-CSF group. Up to now, of the 49 patients, no APBSCT related death occur, 23 have died and 22 of them died of relapse. The most common transplantation related complications were fever, liver dysfunction and hypopotassemia, all of which can be cured by proper treatment. CONCLUSION: APBSCT can be safely performed in hematological malignancies.