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目的探讨恶性淋巴瘤(ML)用MAG方案动员、BEAM方案预处理、自体外周血干细胞移植(APBSCT)的疗效和毒性。方法8 年采用APBSCT 治疗ML14 例[9 例非霍奇金淋巴瘤(NHL),5例霍奇金病(HD)],外周血干细胞动员采用MAG方案(Ara C 2g/m2 q12 h,d1~2,MTZ10 mg·m2d2~3,rhG CSF 300μg/d),为预处理采用BEAM方案(BCNU 250 mg/m2d1,VP 16 200mg2d2~5,Ara C 400 mg/m 2d2~5,Mel 140 mg/m2 d6)。化疗结束后36~48 h回输自体造血干细胞。结果13/14例一次采集即获足量干/祖细胞。回输单个核细胞(MNC)3 91(1 21~6 61)×108/kg、粒单核系祖细胞( CFU GM) 4 40 (2 33 ~ 6 47)×105/kg 和CD34+ 细胞17 79 (4 79 ~30 69)×106/kg。所有患者移植后均获造血重建,中性粒细胞(ANC)≥0 5×109/L时间为10(8~13) d,血小板(Plt)≥20×109/L为13(9~22) d。中位随访时间46(4~100)个月,12 例存活,总生存率85 7%,无病生存率78 5%。结论MAG方案动员/BEAM方案预处理APBSCT治疗ML安全有效。
Objective To investigate the efficacy and toxicity of MAG mobilization, pretreatment with BEAM and autologous peripheral blood stem cell transplantation (APBSCT) in patients with malignant lymphoma (ML). Methods Eight cases were treated with APBSCT for ML14 cases [9 cases of NHL and 5 cases of Hodgkin’s disease (HD)]. The mobilization of peripheral blood stem cells was performed with MAG (q = 2, MTZ 10 mg · m2d2 ~ 3 and rhG CSF 300 μg / d) were used for the pretreatment with the BEAM regimen (BCNU 250 mg / m2d1, VP 16 200 mg2d2-5, Ara C 400 mg / m2d2-5, Mel 140 mg / m2 d6). 36 ~ 48 h after chemotherapy return autologous hematopoietic stem cells. Results A total of 13/14 patients received sufficient dry / progenitor cells once collected. The number of mononuclear progenitor cells (CFU GM) 4 40 (2 33 ~ 6 47) × 105 / kg and the number of CD34 + cells in the mononuclear cells of 3 91 (121 ~ 6 61) × 108 / (4 79 ~ 30 69) × 106 / kg. All patients underwent hematopoietic reconstitution after transplantation. The time for neutrophil (≥0.5 × 109 / L) was 10 (8 ~ 13) d, and the platelet count (≥20 × 109 / L) d. The median follow-up time was 46 (4-100) months. Twelve survived, with a total survival rate of 85.7% and a disease-free survival rate of 78.5%. Conclusions MAG regimen mobilization / BEAM regimen pretreatment APBSCT treatment of ML safe and effective.