论文部分内容阅读
目的 :探讨造血干细胞移植治疗白血病及淋巴瘤的疗效。方法 :采用异基因造血干细胞移植 (包括脐血移植 )治疗慢性粒细胞白血病 ( CGL) 2例、急性淋巴细胞白血病( AL L) 2例和急性髓细胞白血病 ( AML) 1例 ;用自体骨髓和外周血干细胞移植 1 8例 ,包括非霍奇金淋巴瘤 ( NHL) 7例 ,AML5例 ,ALL 3例 ,霍奇金病 ( HD) 2例和 CGL 1例。预处理方案 :异基因者采用 BU/CY2 (马利兰 +环磷酰胺 )或其改良方案 ,自体移植者采用 MAC(马法兰 +阿糖胞苷 +环磷酰胺 )、CBV(环磷酰胺 +卡氮芥 +足叶乙甙 )或 BEAC( CBV+阿糖胞苷 )方案。对 8例自体造血干细胞移植的急性白血病患者序贯定期化疗 ,部分淋巴瘤患者移植后行补救性治疗。结果 :2 3例患者均获造血重建 ,移植相关病死率 4.3% ( 1 /2 3例 )。中位随访时间 32 ( 6～ 70 )个月 ,复发 4例 ,1 8例仍长期无病生存。结论 :造血干细胞移植是治疗白血病及淋巴瘤 ,改善其预后的主要手段之一。急性白血病患者自体造血干细胞移植后仍坚持定期化疗 ,难治性淋巴瘤移植后补救性治疗 ,可使其移植后复发率明显降低。
Objective: To investigate the therapeutic effect of hematopoietic stem cell transplantation on leukemia and lymphoma. Methods: 2 cases of chronic myelogenous leukemia (CGL), 2 cases of acute lymphoblastic leukemia (AL L) and 1 case of acute myeloid leukemia (AML) were treated with allogeneic hematopoietic stem cell transplantation (including cord blood transplantation) 18 cases of peripheral blood stem cell transplantation, including 7 cases of non-Hodgkin’s lymphoma (NHL), 5 cases of AML, 3 cases of ALL, 2 cases of Hodgkin’s disease (HD) and 1 case of CGL. Preconditioning regimens: Allogeneic patients were treated with BU / CY2 (marylan + cyclophosphamide) or its modified regimen. Autografts were treated with MAC (melphalan plus cytarabine + cyclophosphamide), CBV (cyclophosphamide plus carmustine + Etoposide) or BEAC (CBV + cytarabine) regimen. Eight patients with autologous hematopoietic stem cell transplantation in patients with acute leukemia sequential chemotherapy, some patients with lymphoma after salvage treatment. RESULTS: Twenty-three patients underwent hematopoietic reconstitution. The overall mortality rate was 4.3% (1/23 cases). The median follow-up time was 32 (6 ~ 70) months, with 4 recurrent cases and 18 cases still long-term disease-free survival. Conclusion: Hematopoietic stem cell transplantation is one of the main methods to treat leukemia and lymphoma and improve their prognosis. Acute leukemia patients with autologous hematopoietic stem cell transplantation still insisted on regular chemotherapy, refractory lymphoma after transplantation for salvage therapy, can make it significantly reduced the recurrence rate after transplantation.