Objective To evatuate the initiat therapeutic effect of autotogous peripherat blood stem-cett transptantation ( APBSCT) after the routine chemotherapy on matignant tymphoma. Methods Fifty tvvo cases of matignant tymphoma were randomty divided into tvvo groups, eontrot group and transptantation group. The controt group( 26 cases ) was treated with six courses of CHOP or COMP or VDtP or ABVD ptan, the transptantation group( 26 cases ) was treated vvith APBSCT after six-course mutine chemotherapy. Hematopoietic stem cetts were mobitized and cottected by granutocyte colony stimutating factor( G-CSF ) combined vvith high-dose cyctophosphamide( LID-CTX ). The conditioning regimen was CBV. Resutts Twenty six cases were engrafted and hematopoietic reconstitution was rapid: The mean days of ANC recovery up to ＞0. 5 X 10 /t and Ptt up to ＞20 X 10 /t were 10 days and 13 days,respectivety. Comptete remission ( CR ) rate of transptantation group was 80. 77% and that of eontrot group was 34. 62% ; Overatt response rate: 92. 31% vs 61. 54% ,the efficacy of transptantation group was better than that of controt gmup( P ＜0. 05 ). The fottow-up tas ted for 6 -76 months. The 3-year event free Survivat( EFS ) rates of transptantation gmup and controt group were 83.33% ( 15/18 ) and 37.50%( 6/16 ),respectivety ;The 5-yoar EFS rates were 58. 33%( 7/12 ) and 23. 08%( 3/13 ),respectivety. The 3-year,5-year EFS rate of transptantation group were higher than those of controt group( P ＜0. 05 ). Recurrence rate of transptantation group was tower than that of controt group( 19.23% vs 46. 15% ,P ＜0. 05 ). Conctusion APBSCT has better effect than chemotherapy atone for the post-remission treatment of matignant tymphoma,and its recurrence rate is tower than that of chemotherapy atone.%目的 观察恶性淋巴瘤患者在常规化疗后用自体外周血造血干细胞移植作为巩固治疗方法 的初期疗效.方法 52例恶性淋巴瘤患者,按完全随机设计的原则,按入院单号为对照组,双号为移植组.对照组26例采用CHOP、COMP、VDLP、ABVD等常规化疗方案化疗6个疗程.移植组26例在常规化疗基础上行自体外周血造血干细胞移植.动员方案采用大剂量环磷酰胺(HD-CTX)联合粒细胞集落刺激因子(G-CSF);预处理方案采用CBV(环磷酰胺、环己亚硝脲、足叶乙甙).结果 26例患者移植后造血功能快速重建.移植后ANC＞0.5×109/L、Plt＞20×109/L的中位时间分别为10 d、13 d,移植组与对照组的完全缓解率分别为80.77%和34.62%;总有效率分别为92.31%和61.54%,移植组疗效好于对照组(P＜0.05).随访时间6～76个月.移植组和对照组的3年无事件生存率(EFS)分别为83.33%(15/18)和37.50%(6/16),5年EFS分别为58.33%(7/12)和23.08%(3/13),移植组3年、5年EFS均高于对照组(P＜0.05).复发率分别为19.23%和46.15%,移植组复发率低于对照组(P＜0.05).结论 自体外周血造血干细胞移植作为恶性淋巴瘤患者缓解后的巩固治疗比单纯化疗有更好的疗效,复发率较单纯化疗低.
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