摘要
目的 探讨减低强度预处理异基因造血干细胞移植（allo-HSCT）治疗复发难治性淋巴瘤的疗效和安全性.方法 北京军区总医院2012年1月至2013年12月应用减低强度预处理allo-HSCT治疗5例复发难治性淋巴瘤,其中男4例,女1例,平均年龄28.7岁（20～ 39岁）.3例为HLA配型全相合,2例为HLA配型不全相合.供者接受粒细胞集落刺激因子动员,采用骨髓加外周血干细胞联合移植,预处理方案为减低强度的氟达拉滨、白消安及抗人淋巴细胞免疫球蛋白,采用联合免疫抑制剂预防移植物抗宿主病（GVHD）,包括环孢素A、甲氨蝶呤、霉酚酸酯等,移植后观察患者不良反应、GVHD和无病生存等情况.结果 5例患者均获造血重建,中性粒细胞数≥0.5＆#215;109/L及血小板数≥20＆#215; 109/L的平均时间分别为18.8 d及24.5d,植入证据检测为100％完全供者造血.随访至2014年12月,中位随访时间19.2个月（6～35个月）,2例患者死于复发,其余患者处于完全缓解状态,最长无病生存时间达35个月.结论 减低强度预处理allo-HSCT治疗复发难治性淋巴瘤的方案安全、可行,疗效确切,可作为挽救性治疗的关键技术在临床广泛开展.
Objective To explore the efficacy and safety of reduced intensity allogeneic stem cell transplantation （allo-HSCT） in the treatment of relapsed or refractory lymphoma.Methods 5 patients with relapsed or refractory lymphoma received reduced intensity allo-HSCT from January 2012 to December 2013 of Beijing Military General Hospital,including 4 males and 1 female,aged from 20 to 39 years old,with the mean age 28.7 years old.3 cases were HLA-identical matching and the other two cases were HLA-haploidentical.Donors received granulocyte colony-stimulating factor mobilization,and stem cells were collected from both peripheral blood and bone marrow.Pretreatment scheme reduced the strength of pretreatment for fludarabine combined with busulfex and ATG.Combined immunosuppressive agents were used for graft-versus-host disease （GVHD） prophylaxis,including cyclosporine A,methotrexate,mycophenolate mofetil and soon.The toxicity,GVHD and disease-free survival in patients were observed after transplantation.Results All of the patients acquired hematopoietic reconstitution.The average time of the neutrophils count ≥ 0.5×10 9/L and platelets ≥ 20×10 9/L were 18.8 d and 24.5 d,respectively.Implantation was confirmed by the evidence of 100 % of donor hematopoiesis.As of follow-up to December 2014 with the median 19.2 months （6-35 months）,2 cases died of recurrence,the other 3 patients remained disease-free survival,and the longest disease-free survival time was up to 35 months.Conclusions Reduced intensity allogeneic hematopoietic stem cell transplantation is an effective and safe method for relapsed or refractory lymphoma,which could be chosen as a salvage treatment method for relapsed or refractory lymphoma.
出处
《白血病．淋巴瘤》
CAS
2015年第5期270-273,共4页
Journal of Leukemia & Lymphoma
基金
国家自然科学基金（31200686）
关键词
异基因造血干细胞移植
减低强度
复发
难治
淋巴瘤
Allogeneic hematopoietic stem cell transplantation
Rducing strength
Rlapsed
Refractory
Lymphoma
