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目的观察恶性淋巴瘤患者在常规化疗后用自体外周血造血干细胞移植作为巩固治疗方法的初期疗效。方法 52例恶性淋巴瘤患者,按完全随机设计的原则,按入院单号为对照组,双号为移植组。对照组26例采用CHOP、COMP、VDLP、ABVD等常规化疗方案化疗6个疗程。移植组26例在常规化疗基础上行自体外周血造血干细胞移植。动员方案采用大剂量环磷酰胺(HD-CTX)联合粒细胞集落刺激因子(G-CSF);预处理方案采用CBV(环磷酰胺、环己亚硝脲、足叶乙甙)。结果 26例患者移植后造血功能快速重建。移植后ANC>0.5×109/L、Plt>20×109/L的中位时间分别为10 d、13 d,移植组与对照组的完全缓解率分别为80.77%和34.62%;总有效率分别为92.31%和61.54%,移植组疗效好于对照组(P<0.05)。随访时间6～76个月。移植组和对照组的3年无事件生存率(EFS)分别为83.33%(15/18)和37.50%(6/16),5年EFS分别为58.33%(7/12)和23.08%(3/13),移植组3年、5年EFS均高于对照组(P<0.05)。复发率分别为19.23%和46.15%,移植组复发率低于对照组(P<0.05)。结论自体外周血造血干细胞移植作为恶性淋巴瘤患者缓解后的巩固治疗比单纯化疗有更好的疗效,复发率较单纯化疗低。
Objective To observe the initial efficacy of autologous peripheral blood stem cell transplantation as a consolidation treatment for patients with malignant lymphoma after conventional chemotherapy. Methods 52 patients with malignant lymphoma, according to the principle of completely randomized design, according to admission number as the control group, double number for the transplantation group. The control group of 26 patients with CHOP, COMP, VDLP, ABVD and other conventional chemotherapy regimen of 6 courses of chemotherapy. In the transplantation group, 26 patients received autologous peripheral blood stem cell transplantation on the basis of conventional chemotherapy. High-dose cyclophosphamide (HD-CTX) combined with granulocyte-colony stimulating factor (G-CSF) was used in the mobilization program; CBV (cyclophosphamide, cycloheximide, etoposide) was used in the pretreatment regimen. Results Twenty-six patients underwent rapid reconstruction of hematopoietic function after transplantation. The median time of ANC> 0.5 × 109 / L and Plt> 20 × 109 / L after transplantation were 10 days and 13 days, respectively. The complete remission rates of the transplantation group and the control group were 80.77% and 34.62% Which was 92.31% and 61.54% respectively. The curative effect in the transplantation group was better than that in the control group (P <0.05). Follow-up time of 6 to 76 months. The 3-year event-free survival rates (EFS) were 83.33% (15/18) and 37.5% (6/16) in the transplant and control groups, respectively. The 5-year EFS were 58.33% (7/12) and 23.08% / 13). The 3-year and 5-year EFS of the transplantation group were higher than those of the control group (P <0.05). The recurrence rates were 19.23% and 46.15% respectively. The recurrence rate in the transplantation group was lower than that in the control group (P <0.05). Conclusion Autologous peripheral blood stem cell transplantation as a malignant lymphoma in patients with remission after consolidation therapy has better efficacy than chemotherapy alone, the recurrence rate was lower than chemotherapy alone.