摘要
目的 观察外周血干细胞移植 (PBSCT)治疗恶性血液病及实体瘤的初期疗效。方法 自 2 0 0 1年 3月至 2 0 0 2年 3月 ,用PBSCT治疗恶性血液病及实体瘤患者共 2 1例 (含儿童患者 10例 ) ,其中 :急性淋巴细胞白血病 (ALL) 8例 ;急性非淋巴细胞白血病 (ANLL) 1例 ;非霍奇金淋巴病 (NHL) 8例 ;霍奇金淋巴瘤 (HD) 2例 ;多发性骨髓瘤 (MM ) 1例 ;小细胞肿癌 (SCLC) 1例。除 1例异基因和 1例同基因移植患者采用G CSF对供者进行动员外 ,其他病例均为自体外周血干细胞移植 ,动员方案为化疗 +G CSF。经 2～ 4次采集 ,获得MNC中位数为 5 2× 10 8 kg ,CD3 4+ 细胞为 6 4× 10 6 kg ,CFU GM为 3 6× 10 5 kg。预处理方案 :17例患者采用Cy TBI,4例患者采用高剂量化疗方案。结果 所有患者移植后均重建造血。外周血WBC于移植后 4 4± 2 5d降至 0。PLT于 7 6±2 2d降至 10× 10 9 L以下。WBC >1 0× 10 9 L、中性粒细胞 >0 5× 10 9 L、PLT >2 0× 10 9 L ,分别为 10± 3d、11± 3d、15± 7d。 5例患者于移植后 1～ 6个月死于感染或病情复发 ,其余患者均无病存活 2～ 11个月 ,疗效仍在近一步随访中。结论 PBSCT对儿童及成人恶性血液病、实体肿瘤都是一种安全有效的治疗方法。
Objective To evaluate the therapeutic effects of peripheral blood stem cell transplantation (PBSCT) on the treatment of hematologic malignancies and solid tumors. Methods Twenty one patients(including 10 cases of children) with hematologic malignancies and solid tumors were treated by PBSCT from March 2001 to March 2002. Eight of them were ALL, 1 ANLL, 8 NHL, 2 HD, 1MM, and one SCLC. In one patient who received synogeneic PBSCT (Syn PBSCT) and one who received allogeneic PBSCT, the donors received G CSF at a dose of 10 mg/kg/d by subcutaneous injection for 5 d for PBSC mobilization. Other patients received autologous PBSCT (APBSCT) combined with chemotherapy regimen followed by G CSF. PBSCs were collected in two four aphereses to a median mononuclear cells (MNC) of 5.2×10 8/kg, CD34+ cells 6.4×10 6/kg and CFU GM 3.6×10 5/kg. Seventeen patients received TBI/Cy and 4 received C(I)EAC (CCNU, ID, VP16, Ara C, Cy) as conditioning regimen respectively. Results All patients were engrafted and hematopoietic reconstitution was rapid. The average days of WBC recovery were 10 days up to > 1.0 ×10 9/L,ANC 11days up to 0.5>×10 9/L and PLT 15 days up to >20×10 9/L. Of the patients, five died of infection or disease relapse 1～6 months after transplantation but others are still alive and disease free for 2～11 months. Conclusion PBSCT is a secure therapeutic option that can significantly improve the prognosis in hematologic malignancies and solid tumors of both children and adult patients.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2002年第12期1473-1474,共2页
Journal of Third Military Medical University
关键词
临床观察
恶性血液病
实体瘤
外周血干细胞移植
hematologic malignancies
solid tumor
peripheral blood stem cell transplantation
