淋巴瘤自体外周血造血干细胞移植12例

目的：探讨自体造外周血造血干细胞移植治疗有多个预后不良因素和难治或复发淋巴瘤的疗效及安全性。方法：2005年2006年采用大剂量化疗加自体外周血造血干细胞支持治疗淋巴瘤的患者12例,其中非霍奇金淋巴瘤（NHL）的患者10例,霍奇金淋巴瘤的患者（HL）2例,动员方案：NHL的患者给予Hy-per-CVAD方案（CTX 2.5 g/m^2、VCR 2 mg、ADR 60 mg/m^2、DEX 40 mg）、DOAME方案（DEX 40 mg、VCR 2 mg、MTZ 10 mg/m^2、ARA-C 3 g/m^2、VP-16 200 mg/m^2）、DICE（Dex 40 mgI、FO 4 g/m^2、VP-16 400 mg、DDP 100 mg/m^2）,HL的患者给予CTX 4 g/m^2、DOAME方案,4例CD20＋的B细胞NHL患者加用美罗化进行体内净化,预处理方案采用BEAC（BCNU 300 mg/m^2、VP-16 1200 mg/m^2,ARA-C1.8 g/m^2,CTX 3.6 g/m^2）,肿块大于4 cm的移植后给予补救性放疗。结果：所有患者随访半年,12例患者中11例获CR,1例患者SD,移植2个月后进展,行异基因造血干细胞移植。结论：常规化疗有效患者造血干细胞移植后疗效好,对常规化疗耐药患者疗效差,安全性好、费用低,是难治或复发和有多个不良因素患者的选择,远期疗效目前正在随访中。

12 Cases of Autologous Peripheral Blood Stem Cell Transplantation for Malignant Lymphoma Treatment

Objective：To investigate autologous peripheral blood stem cell transplantation for malignant lymphoma of relapse/refractory and with multi-unfaverable factor.Methods： From 2005 to 2006,twelve patients,10 cases of NHL and 2 cases of HL were enter into the investigation.Mobilization： Hyper-CVAD（CTX 2.5 g/m^2 、VCR 2 mg 、ADR 60 mg/ m^2 、DEX 40 mg） or DOAME（DEX 40 mg、VCR 2 mg、MD-ARA-C 3 g/ m2、VP-16 200 mg/ m^2 MTZ10 mg/ m^2） or DICE（DEX 40、IFO 4 g/ m^2、DDP 100 mg/ m^2、VP-16 300 mg/ m^2）,for NHL.CTX 4 g/m^2 or DOAME for HL,Conditioning regime： BEAC（BCNU 300 mg/m^2、VP-16 1200 mg/m^2,ARA-C1.8 g/m^2,CTX 3.6 g/m2）,Patients whose tumer large than 4 cm were given salvage radiotherapy.Results： After a media follow-up 6（4-9） months,11 patients achieved complete remission（CR）.and 1 patient with stable disease（SD） who developed progressive disease accepted allo-peripheriral blood stem cell transplantation two months later.Conclusion：Patients who sensitive to conventional chemotherapy have a good prognostic than refractories,and who non-sensitive to conventional chemotherapy is not surperior to conventional chemotherapy.No transplant-ralate mortality was found.