论文部分内容阅读
目的 回顾性分析自体外周血干细胞移植 (APBSCT)治疗血液恶性病及实体瘤的疗效。方法 51例患血液及实体肿瘤患者接受自体外周血干细胞移植 ,本文就移植过程中干细胞采集时间、干细胞回输量、骨髓重建时间、移植后各类疾病无病生存期及总体生存期、移植相关并发症、移植后维持化疗等问题进行总结和探讨。结果 (1)与常规化疗相比 ,自体外周血干细胞移植可延长移植患者的总体生存期及无病生存期 ,其顺序为NHL>AML >MM >ALL ;3年及 5年生存率AML和NHL组分别为 74 78%和 83 33% ,MM组为 38 0 %和 19 0 % ,ALL组为 4 0 0 %和 0 %。 (2 )移植后骨髓造血重建时间未用G CSF组干细胞回输后平均第 17 6天外周血白细胞恢复至 >0 5× 10 9/L ,用G CSF组平均 11 14天。 (3)移植相关并发症以发热 ,肝功能受损和低钾最常见。经治疗上述并发症均可逆转 ,尚未发现VOD或不可逆性肝损害 ,无移植相关死亡。移植后随访 7年中 ,共死亡 2 1例 ,其中 2 0例死于复发 ,主要为ALL和MM患者。结论 APBSCT已成为治疗血液恶性病及某些实体瘤、改善其预后的重要手段 ,尤其可明显延长AML及NHL患者的无病生存期及总体生存期
Objective To retrospectively analyze the efficacy of autologous peripheral blood stem cell transplantation (APBSCT) in the treatment of hematological malignancies and solid tumors. Methods 51 patients with hematologic and solid tumors received autologous peripheral blood stem cell transplantation. This article involved stem cell collection time, stem cell refusion volume, bone marrow reconstitution time, disease-free survival and overall survival after transplantation, and transplantation related to transplantation. Complications, maintenance of chemotherapy after transplantation and other issues are summarized and discussed. Results (1) Compared with conventional chemotherapy, autologous peripheral blood stem cell transplantation can prolong the overall survival and disease-free survival of transplanted patients. The order is NHL>AML>MM>ALL; 3-year and 5-year survival rates AML and NHL The group was 74 78% and 83 33% respectively, the MM group was 30% and 190%, and the ALL group was 40% and 0%. (2) After bone marrow hematopoietic reconstitution after transplantation, peripheral blood leukocytes returned to >0 5×10 9/L on the 17th day after GSCSF stem cell transfusion, and on average 11 14 days with G CSF group. (3) Transplant-related complications include fever, impaired liver function, and hypokalemia are the most common. After the treatment of these complications can be reversed, no VOD or irreversible liver damage has been found, and no transplant-related deaths. In the follow-up period of 7 years after transplantation, a total of 21 deaths occurred. Among them, 20 cases died of relapse, mainly in ALL and MM patients. Conclusion APBSCT has become an important method to treat hematological malignancies and some solid tumors and improve their prognosis. It can significantly prolong the disease-free survival and overall survival of patients with AML and NHL.