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目的:探讨自体外周血干细胞移植(APBSCT)联合过继免疫治疗霍奇金淋巴瘤(HL)的疗效。方法:以32例HL患者作为治疗组,交替应用ABVD方案、TAOP方案和MEOP方案各2个疗程化疗后,以化疗+重组人粒细胞集落刺激因子方法动员自体外周血干细胞,TBI+VEMAC方案预处理,进行APBSCT。造血恢复后每个月给予重组人白细胞介素-2 100 WU/d×10d的过继免疫治疗,共6个疗程。以22例HL患者作为对照组,化疗及移植方案同上,未给予后续治疗。随访时间5年。结果:2组患者移植后1个月内均实现造血重建并全部处于完全缓解。随访1年时,2组患者的无病生存(DFS)率均为100%(P>0.05),随访3年、5年时,2组的DFS率分别为93.8%、84.4%和72.7%、59.1%,差异有统计学意义(P<0.05)。随访1年时,2组间Ⅲ/Ⅳ期患者的DFS率均为100%(P>0.05),随访3年、5年时,2组间Ⅲ/Ⅳ期患者的DFS率分别为91.3%、82.6%和64.7%、52.9%,差异有统计学意义(P<0.05)。结论:APBSCT联合过继免疫治疗HL疗效显著,尤其Ⅲ/Ⅳ期患者获益明显。
Objective: To investigate the efficacy of autologous peripheral blood stem cell transplantation (APBSCT) combined with adoptive immunotherapy for Hodgkin’s lymphoma (HL). Methods: A total of 32 HL patients were treated with ABVD, TAOP and MEOP respectively. After 2 courses of chemotherapy, the peripheral blood stem cells were mobilized by chemotherapy and recombinant human granulocyte-colony-stimulating factor. TBI + VEMAC Processing, APBSCT. After the hematopoietic recovery, the recombinant human interleukin-2 100 WU / d × 10d was given a total of 6 courses every month. 22 cases of HL patients as a control group, chemotherapy and transplantation program as above, did not give follow-up treatment. Follow-up time of 5 years. Results: All patients in two groups achieved hematopoietic reconstitution within one month after transplantation and all were in complete remission. The follow-up of 1 year, the two groups of patients with disease-free survival (DFS) were 100% (P> 0.05), followed up for 3 years, 5 years, the two groups DFS rates were 93.8%, 84.4% and 72.7% 59.1%, the difference was statistically significant (P <0.05). At one year follow-up, the DFS rates of stage III / IV patients in both groups were 100% (P> 0.05). After 3 years and 5 years of follow-up, the DFS rates were 91.3% 82.6% and 64.7%, 52.9% respectively, the difference was statistically significant (P <0.05). Conclusion: APBSCT combined with adoptive immunotherapy has a significant effect on HL, especially in patients with stage Ⅲ / Ⅳ.