SEAM预处理方案用于复发难治非霍奇金淋巴瘤自体造血干细胞移植的效果分析

目的:探讨SEAM（司莫司汀、依托泊苷、阿糖胞苷及美法仑）方案预处理自体造血干细胞移植（auto-HSCT）治疗复发难治非霍奇金淋巴瘤患者的效果及不良反应。方法:回顾性分析2015年1月至2020年9月于解放军联勤保障部队第九二○医院以SEAM方案预处理auto-HSCT治疗的20例非霍奇金淋巴瘤患者临床资料，观察预处理相关不良反应、移植后造血功能的恢复情况及疾病转归。结果:20例患者中，SEAM方案预处理过程中发生肺部感染1例，恶心、呕吐8例，腹泻3例，发热1例，肺损伤1例，黏膜炎1例。16例患者auto-HSCT后造血功能重建，达粒细胞植入（中性粒细胞≥0.5×10 9/L）的中位时间13 d（8~30 d），达血小板植入（血小板计数≥20×10 9/L）的中位时间13 d（9~37 d）。中位随访时间27个月（3~65个月）。16例（80%）无病生存，4例死亡，无患者复发和进展，非复发死亡率20%。 结论:行auto-HSCT的非霍奇金淋巴瘤患者对SEAM预处理方案有较好的耐受性，不良反应较小，造血重建恢复快，疗效较好。

Efficacy analysis of SEAM preconditioning regimen followed by autologous hematopoietic stem cell transplantation in relapsed/refractory non-Hodgkin lymphoma

Objective:To investigate the efficacy and adverse effects of SEAM (semustine, etoposide, cytarabine and melphalan) preconditioning regimen followed by autologous hematopoietic stem cell transplantation (auto-HSCT) in treatment of patients with relapsed/refractory non-Hodgkin's lymphoma (NHL).Methods:The clinical data of 20 NHL patients receiveing conditioning regimen followed by auto-HSCT in 920th Hospital of PLA Joint Logistic Support Force from January 2015 to September 2020 were retrospectively analyzed. The pretreatment-related adverse effects, recovery of hematopoietic function after transplantation, and disease prognosis were observed.Results:During the pretreatment of 20 patients, 1 patient had pulmonary infection, 8 patients had nausea and vomiting, 3 patients had diarrhea, 1 patient had fever, 1 patient had lung injury, and 1 patient had mucositis. After auto-HSCT, 16 patients achieved hematopoietic reconstruction, the median time of neutrophil engraftment (neutrophil ≥0.5×10 9/L) was 13 d (8-30 d) and the median time of platelet engraftment (platelets ≥20×10 9/L) was 13 d (9-37 d). The median follow-up time was 27 months (3-65 months). Until the end of the follow-up, 16 (80%) patients had disease-free survival, 4 patients died, and no patient had recurrence and disease progression; non-relapse mortality was 20%. Conclusions:SEAM conditioning regimen followed by auto-HSCT has a better tolerance, less adverse events, quick recovery of hematopoietic reconstruction and good efficacy for NHL patients.