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【摘要】 本研究探讨造血干细胞移植(HSCT)对恶性淋巴系统血液病的疗效。通过8例非霍奇金淋巴瘤(NHL)及3例淋巴细胞白血病患者在前期化疗基础上进行造血干细胞移植,分别观察造血重建、并发症及生存期等指标,以了解造血干细胞移植对该类疾病的疗效。结果表明:HSCT后11例患者(其中自体移植7例,异基因移植4例)造血顺利恢复,均能达到完全缓解(CR)。随访3年,5例NHL患者无病生存,1例NHL患者于移植后2个月死亡,1例自杀;4例接受异基因造血干细胞移植的患者中,1例非霍奇金淋巴瘤(NK细胞型)移植后79天死亡,1例慢性淋巴细胞白血病患者无病生存,2例急性淋巴细胞白血病患者分别于移植后第54天、第17个月死亡。结论:造血干细胞移植是治疗恶性淋巴系统血液疾病的一个有效手段,但自体HSCT的患者尚有一定的复发率,而异基因HSCT患者有可能因严重的移植相关并发症而死亡。 / `8 Y ~; v, i6 u) K! ` 【关键词】造血干细胞移植;淋巴瘤;淋巴细胞白血病) D; \/ m- {/ }. U2 S% ?
Effect of Hematopoietic Stem Cell Transplantation in Malignant Hematologic Disease of Lymphatic System ; n! ?3 K* Q. F3 y6 b# ? % J- k3 G% J! s2 ^ SONG Hui-Hui,CHEN Bao-An, DING Jia-Hua,SUN Xue-Mei,GAO Chong,SUN Yun-Yu, WANG Jun,CHENG Jian,ZHAO Gang( @3 `, M" U9 P) {$ _3 ~0 n
$ ^$ D8 u- i/ j' U( q0 G Department of Hemotology, Zhongda Hospital Affiliated to Southeast University,Nanjing 210009,China;1Department of Hemotology, Gulou Hospital, Nanjing 210008,China ; S" {4 ]- x" k! r3 a% x" _! `. \% H1 e0 O/ `% L8 k6 m* S
AbstractThe study was aimed to investigate the effect of hematopoietic stem cells transplantation (HSCT) in treatment for hematologic maglignaciesof lymphatic system. Through observing 8 patients with non-Hodgkin′s lymphoma (NHL) and 3 patients with lymphoblastic leukemia, who received auto or allo-HSCTafter chemotheraphy, the hematopoietic reconstitution, complication and surviral timewere evaluated. The results showed that11 patients (7 patients after auto-PBSCT, 4 patients after allo-PBSCT) all achieved hematopoietic reconstitution and complete remission (CR). Withinthree years following-up, 5 patients with NHL were survival, but one case of NHL died at the 2 months after auto-PBSCT, one patient suicided. From4 cases received allo-PBSCT,one patiant with NHL (NK cell) was died at 79 days later, one patient with chronic lymphoblastic leukemia was surviving, another 2 cases of acute lymphoblastic leukemia were dead at 17 monthsand 54 days respectivelyafter allo-PBSCT. In conclusionHSCT is an effective treatment for hematologic maglignancies of lymphatic system, but the replase would occur in some patients received auto-PBSCT. The others by allo-PBSCT might die of severe complication of transplantation.6 L( S2 ]+ q: @. n3 k" o/ N+ i% Y
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7陈宝安,熊辉霞,丁家华等.非清髓异基因外周造血干细胞移植治疗难治性恶性血液病.临床肿瘤学杂志,2005;10:14-17 5 J* c2 x5 t4 a; K( d / t' s, d. K" x 2 p5 o% D& m5 A0 d2 m! B4 a" B0 d# v6 @( g6 V
8张之南.血液病诊断及疗效标准.北京:科学出版社出版,1998: 342-3494 n& g( Z5 ]7 C6 Q6 e
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2 r% |1 b P' O4 G2 m" ] 9Gutierrez-Dekgado F,Maloney DG,Pressow OW,et al. Autologous stem cell trasplantation for non-Hodgkin′s lymphoma: comparison of rediation-based and chemotherapy-only preparative regimens. Bone Marrow Transplant, 2001;28;455-461 / H; ~0 v/ ~+ B; f5 O4 G* J# T( V7 R+ j8 c# ~% L
( o N$ u6 I F# ^, F( L, K , w& ]3 c" X6 k. f 10 Vose JM,Zhang MJ,Rowlings PA,et al. Autologous transplantation for diffuse aggressive non-Hodgkin′s lymphoma in patients never achieving remission:a report from the autologous blood and marrow transplant registry. J Clin Oncol, 2001;19:406-4131 T$ O: z8 A; b# S2 y) |. G
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11 Vaishampayan U, Karanes C, Du W, et al. Outcome of relapsed non-Hodgkin′s lymphoma patients after allogeneic and autologous transplantation. Cancer Invest,2002;20:303-310 2 |( z% n6 T- D( O' O# V- Y( ?3 t7 B) k5 B
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. u! d& V' P3 B _' R# Z3 I 12Mitterbauer M, Neumeister P, Kalh P, et al. Long-term clinical and molecular remission after allogeneic stem cell transplantation(SCT) in patients with poor prognosis non-Hodgkin′s lymphoma. Leukemia,2001;15:635-6410 G) Y1 g" n% x% q# _3 E1 j9 z
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: k/ Z' W* m( i% ^+ Z% H% t 13 Rossi HA, Becker PS, Emmons RV, et al. High-dose cyclophosphamide, BCNU, and VP16 (CBV) conditioning before allogeneic stem cell transplantation for patients with non-Hodgkin′s lymphoma. Bone Marrow Transplant,2003;31:441-446+ Y$ u( }* h, Z& y
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$ ]5 q8 p+ a. m2 }& l 14 Pavletic ZS, Arrowsmith ER, Bierman PJ, et al. Outcome of allogeneic stem cells transplantation for B cell chronic lymphocytic leukemia. Bone Marrow Transplant, 2000;25:717-722.作者: s06806 时间: 2015-6-18 13:27