利妥昔单抗联合APBSCT治疗B细胞性非霍奇金淋巴瘤的临床研究

摘要

Objective To evaluate the therapeutic effect of rituximab combined with autologous peripheral blood stem cell trans-plantation(APBSCT)in treatment of aggressive or refractory and recrrent B-cell non-Hodgkin′s lymphoma.Methods Forty-four patients with aggressive or refractory and recrrent B-cell non-Hodgkin′s lymphoma and treated with APBSCT in this department from Janauary 2007 to October 2013 were admitted.All the subjects were divided into 2 groups according to their own choice:22 pa-tients received rituximab treatment(treatment group)and 22 patients were treated without rituximab treatment(control group).For patients in treatment group,rituximab was used with chemotherapy or mobilization of stem cells before APBSCT for (2.9±1.1) times.After transplantation,IL-2 was used in both groups as maintenance treatment.And rituximab was used in the treatment group if the budget allows.Results The mononuclear cell count in treatment and control group was (13.01±4.22)×108/kg and (11.63±2.95)×108/kg(P=0.214).Hematopoietic reconstruction was successfully achieved in the both groups.No significant difference was found between 2 groups on the recovery time of neutrophilic granulocytes and platelets(P>0.05).All patients a-chieved complete remission(CR),at a median follow-up of 20 months(2-73 months),the disease relapsed in 2 patients in treatment group and 5 in control group.The 2-year overall survival rate in treatment group and control group were 95.0% and 75.1%,2-year progression-free survival rates were 82.4% and 74.5%,there were no significant difference between two groups(P=0.179, 0.393).Conclusion Rituximab combined with APBSCT in treatment of aggressive or refractory and recurrent B-cell lymphoma is feasible,however whether patients can benefit from long-term studies still need further research.Adding rituximab does not affect the hematopoietic stem cell collection and hematopoietic reconstitution.%目的：探讨利妥昔单抗联合自体外周血造血干细胞移植（APBSCT）治疗 B细胞性非霍奇金淋巴瘤的疗效。方法回顾分析该院2007年1月至2013年10月44例确诊为侵袭性或复发难治性 B细胞淋巴瘤并接受 APBSCT治疗的患者临床资料。分为两组，治疗组（n＝22）：APBSCT前应用利妥昔单抗联合化疗或动员造血干细胞（2．9±1．1）次，移植后有条件患者采用利妥昔单抗加白细胞介素-2（IL-2）维持治疗；对照组（n＝22）：除未使用利妥昔单抗，其余处理与治疗组相同。结果治疗组和对照组采集单核细胞数分别为（13．01±4．22）×108/kg和（11．63±2．95）×108/kg（P＝0．214）。两组均顺利完成造血重建。两组中性粒细胞恢复时间和血小板恢复时间差异无统计学意义（P＞0．05）。移植后两组病例均达到完全缓解（CR），中位随访时间20（2～73）个月，治疗组2例复发，对照组5例复发。治疗组和对照组2年总生存率分别为95．0％和75．1％，差异无统计学意义（P＝0．179），2年疾病无进展生存率分别为82．4％和74．5％，差异无统计学意义（P＝0．393）。结论利妥昔单抗联合 APBSCT治疗侵袭性和（或）复发难治性B细胞非霍奇金淋巴瘤是可行的，但是否能使患者长期获益仍需要进一步研究。利妥昔单抗的加入不影响造血干细胞采集和造血重建。