【摘要】 目的:观察以大剂量米托蒽醌为主的预处理方案联合自体外周血干细胞移植治疗血液系统恶性肿瘤的毒性反应及临床疗效。方法:39例患者,男22例,女17例,平均年龄(35.69±11.49)岁(12~59)岁。动员方案:CTX加VP16加rhG-CSF,采集单个核细胞(MNC)(3.62±1.69)×108/kg,CD34+细胞(4.31±3.16)×106/kg。预处理一组22例采取米托蒽醌30mg/m2联合CTX、Vp-16化疗和全淋巴结照射(TLI);另一组17例予NVT60mg/m2,联合CTX、Vp-16,或加用卡铂或阿糖胞苷。结果:主要非血液系统毒性为呕吐100%(39/39)、腹泻25.64%(10/39)、黏膜溃疡33.33%(13/39)、皮疹23.08%(9/39),无严重不可逆的脏器功能损害。所有患者均获造血重建。白细胞计数>1.0×109/L的时间是(14.05±3.69)d(8~24)d;血小板计数>20×109/L的时间是(14.86±5.69)d(9~37d)。全组随访时间截至2005年5月,中位生存期19(2~88)个月,复发13例,占33%(13/39)。结论:大剂量米托蒽醌为主的预处理方案联合自体外周血干细胞移植治疗血液系统恶性肿瘤是安全的。更多还原

【Abstract】 Objective:To observe the toxicities and efficacy of autologous peripheral blood stem cell transplantation with high-dose mitoxantrone based regimen.Method:39 patients, with 22 males and 17 females. Mean age was 35.69 ± 11.49 year-old (range 12~59). Mobilization regimen: CTX+VP16+rhG-CSF. The number of mononuclear cells collected was ( 3.62 ± 1.69 )×10~8/kg, CD34~+ cells were ( 4.31 ± 3.16 )×10~6/kg. Patients entered randomizedly to 2 groups. 22 patients in group 1 received mitoxantrone 30 mg/m~2 , CTX and Vp-16 plus total lymph nodes irradiation (TLI). 17 patients in group 2 received mitoxantrone 60 mg/m~2 combined with CTX, Vp-16, or with carboplantin or Ara-C.Result:The common non-hematopoietic toxicities were vomiting (100%, 39 of 39), diarrhea ( 25.64 %, 10 of 39), mucosal ulcer ( 33.33 %, 13 of 39), rash ( 23.08 %, 9 of 39). No severe irreversible organ function insufficiency was observed. All patients reached hematopoietic reconstitution. The time for white blood cell count to reach higher than 1.0 ×10~9/L was ( 14.05 ± 3.69 ) days (8~24 days), and that for platelet count to reach higher than 20×10~9/L was ( 14.86 ± 5.69 ) days (9~37 days). By the time of May 2005, the median survival was 19 months (2~88 months), 13 patients (33%, 13/39) replased.Conclusion:It was safe to treat hematopoietic malignancies with high-dose mitoxantrone based condition regimen followed by autologous peripheral blood stem cell transplantation.更多还原