利妥昔单抗联合自体外周血造血干细胞移植治疗高危侵袭及难治复发性B-NHL的疗效分析

目的:探讨利妥昔单抗(R)联合自体外周血造血干细胞移植(auto-HSCT)治疗高危侵袭性及难治复发CD20+B细胞非霍奇金淋巴瘤(B-NHL)的疗效.方法:选取本中心2005年1月-2013年12月确诊为高危侵袭性及难治复发CD20+B-NHL、并行auto-HSCT治疗的患者资料83例.联合R治疗的患者为观察组,共...

Clinical Efficiency of Rituximab Combined with Autologous Hematopoietic Blood Stem Cell Transplantation for Treatment of CD20^+B non-Hodgkin Lymphoma

Objective;To investigate the effeciency of autologous hematopoietic stem cell transplantation(auto-HSCT)combined with rituximab(R)to treat CD20^+B non-Hodgkin lymphoma(B-NHL).Methods:From January 2005 to December 2013,83 patients with refractory/recurrent CD20^+B-NHL who were treated with auto-HSCT in our department were enrolled.The patients were divided into 2 groups:57 patients in Rituximab group,and 26 patients in control group(without Rituximab).All the patients received chemotherapy and auto-HSCT.For the patients in treatment group,Tituximab was used before transplantation of the stem cells,and for some patients Rituximab was used after transplantation.For the patients in control group,the induction,enhancement and transplantation were the same as those in treatment group.The clinical efficiency of the patients in treatment group according to the time and frequency of R was analyzed in subgroups and compared with the control group.The deadline of follow-up was April 302014.Results:All the patient achieved complete response.The median follow-up time was 39 months.Both the two groups collected peripheral blood stem cells successfully,and had no difference in hematopoietic reconstitution time.Three patients in treatment group and six patients in control group relapsed and the three year overall survival and EFS in treatment group was significantly higher than that in control group,that is(93.0%vs 73.1%,P=0.037)and(89.5%vs 65.4%,P=0.034),respectively.Subgroup analysis showed that;compared with the treatment group in which using R in the whole courses(before and after transplantation,and collection of stem cells)was superior to the control group in both OS and EFS,with the OS 97%vs 87.5%(P>0.05)and EFS 97%vs76.2%(P=0.05)respectively.While stratified by the different courses ofrituximab,the OS was 88.9%(1-2 courses,9 cases),93.1%(3-4 courses,29 cases),94.7%(more than 5 courses,19 cases),and EFS was 77.8%,89.7%and 94.7%,respectively.Conclusion:For the patients with refractory/recurrent CD20^+B-NHL,the combination of R and inducing chemotheraphy,purify in body before transplantation,as well as continue with R after auto-HSCT could obviously improve the OS and EFS of patients.For the patients who with R before and after transplantation,their EFS is better than the patients with R before transplantation only.