基于Hyper-CVAD/MA方案的强化化疗后自体外周血干细胞移植治疗淋巴瘤的研究

目的探讨以Hyper-CVAD/MA方案为基础的大剂量强化化疗后行自体外周血干细胞移植(APBSCT)治疗恶性淋巴瘤的方法和疗效。方法 23例恶性淋巴瘤患者采用CHOP方案常规化疗;每2～3个化疗疗程后予Hyper-CVAD/MA方案强化及利妥昔单抗治疗;APBSCT前患者接受预处理,预处理方案为NEAC(12例)、NEAM(8例)及NEAM+TBI(3例)方案;5例弥漫性大B细胞型、1例套细胞型及1例滤泡细胞型(Ⅲb级)患者于移植前加用利妥昔单抗。结果全部患者均获造血功能重建,移植后患者达到外周血绝对中性粒细胞计数(ANC)≥0.5×109/L、血小板(PLT)≥20×109/L的时间分别为(12.8±2.5)、(16.1±4.1)d。随访45～1 092d,15例患者无病生存,5例复发,3例死亡。患者总生存率及无病生存率分别为86.96%(20/23)及65.22%(15/23)。结论以Hyper-CVAD/MA方案为基础的大剂量强化化疗后行APBSCT治疗恶性淋巴瘤可提高患者无病生存率,安全性较好。

A study of malignant lymphoma treatment using Hyper-CVAD/MA regimen-based intensive chemotherapy followed by autologous peripheral blood stem cell transplantation

Objective To discuss Hyper-CVAD/MA regimen-based high-dose intensive chemotherapy followed by autologous peripheral blood stem cell transplantation(APBSCT) for malignant lymphoma treatment and its therapeutic effect.Methods 23 patients with malignant lymphoma were subjected to conventional CHOP chemotherapy.After every 2-3 courses of the conventional chemotherapy,Hyper-CVAD/MA regimen was employed for intension and rituximab was administrated.Preparative regimen including NEAC(12 cases),NEAM(8 cases) and NEAM+TBI(3 cases) was conducted before APBSCT.5 patients with diffuse large B-cell type lymphoma,1 patient with mantle cell type lymphoma and 1 patient with follicular cell type(Ⅲ b stage) lymphoma were treated with rituximab in addition before APBSCT.Results All patients received successful hematopoietic reconstitution.After transplantation,the duration of their peripheral blood absolute neutrophil count(ANC) achieving ≥0.5×109/L and the platelet(PLT) achieving≥20×109/L were(12.8±2.5) d and(16.1±4.1) d,respectively.The follow-up of 45-1 092 days showed 15 disease-free survival,5 recurrence and 3 dead.The overall survival rate and disease-free survival rate of patients were 86.96%(20/23) and 65.22%(15/23),respectively.Conclusion Hyper-CVAD/MA regimen-based high-dose intensive chemotherapy followed by APBSCT for malignant lymphoma treatment is safe and may improve the disease-free survival rate of patients.