【摘要】 目的:探讨自体外周血干细胞移植(APBSCT)治疗T细胞淋巴瘤的临床疗效和安全性。方法:2000年7月～2008年4月,行APBSCT的T细胞淋巴瘤患者共17例,包括T淋巴母细胞淋巴瘤10例,鼻型NK/T淋巴瘤4例,外周细胞T淋巴瘤2例,间变大细胞淋巴瘤1例。按照AnnArbor标准和IPI分期评分。8例患者的采集物采用CD34+细胞纯化。所有患者均采用CTX+VP-16+TBI预处理方案。结果:(1)所有患者移植后造血功能均顺利重建,中性粒细胞恢复至0.5×109/L为移植后(12.18±2.63)天,血小板恢复至20×109/L为移植后(14.50±4.02)天。(2)中位随访7个月(1～94个月),2年预期的无疾病生存率为62.89%,总生存率为71.87%。(3)随访2年以上未复发的6例患者,均无病存活,中位随访54个月(24～94个月)。(4)死亡均发生在移植后半年内,移植前未缓解的2例患者移植后均死亡,移植前处于复发状态的患者移植后3个月时再次出现复发,带病生存。(5)至随访截止时间,获完全缓解患者行或未行CD34+细胞分选移植的疗效无明显差别。结论:APBSCT对移植前完全缓解和部分缓解的T细胞淋巴瘤患者疗效较好,造血重建顺利,且安全性好,但复发和原发难治的患者疗效相对差,应考虑选择异基因造血干细胞移植治疗。更多还原

【Abstract】 Objective:To analyze retrospectively the results of treatment with autologous peripheral blood stem cell transplantation(APBSCT) for T cell lymphoma(TCL).Methods:To conduct a review of patients who underwent APBSCT for TCL from July 2000 to April 2008.Seventeen cases were identified consisting of 10 cases lymphoblastic lymphoma,4 cases nasal type extranodal NK/T,2 cases peripheral T cell lymphomas,and 1 case anaplastic large cell lymphomas.The patients were classified by Ann Arbor staging system and international prognosis index(IP1).CD34+ cell purification of PBSC were carried out in 8 patients.All the patients received the high-dose chemotherapy with cyclophosphamide,etoposide and total body irradiation(TBI) as conditioning regimen.Results:Platelet recovery(>20×109/L)time was(14.5±4.02) days and leukocyte recovery(>0.5×109/L) time was(12.18±2.63) days,which was within the expected ranges.After median follow-up of 7(1-94)months,the probabilities of 2-year overall survival and disease-free survival after transplantation were 71.87% and 62.89%,respectively.Six patients were still in disease-free survival after two years of APBSCT with follow-up of 54(24-94)months.Four cases were dead within half a year after APBSCT including 2 cases of non-remission before receiving autograft,and patients in relapse before transplantation relapsed again after 3 months and were still alive with disease.There was no significant difference on the outcome among the patients of complete response whether or not receiving autologous CD34+ cell transplantation by the time of stopping follow-up.Conclusion:APBSCT as consolidation therapy in first complete or partial response TCL patients may offer a durable survival benefit.However,there was minimal durable benefit in patients with relapsed or refractory TCL after autotransplantion and allogeneic HCT should be more aggressively explored for them.更多还原