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目的探讨自体造血干细胞移植(AHSCT)治疗恶性血液病及实体瘤的疗效。方法1996年5月至2005年2月广州医学院第一附属医院肿瘤血液中心用AHSCT治疗的白血病及恶性淋巴瘤患者共20例,年龄18～50岁。预处理化疗方案选用以下药物中任意2种或3种联合:阿糖胞苷3～4g/m2,环磷酰胺4～6g/m2,依托泊苷(VP-16)0.5～1.0g/m2,司莫司汀300mg/m2,马法兰140mg/m2,塞替哌600mg/m2,卡铂1.0g/m2,白消安(Bu)16mg/kg。除2例ALL联合全身照射(剂量为8Gy)外,其余均单用化疗。结果所有患者移植后均重建造血,无移植相关死亡;随访中位值39.5(2～109)个月,无病生存者15例,占全部移植患者的75.0%。其中无病生存1年12例(60%),2年8例(40%),3年8例(40%),最长存活9年余。结论自体造血干细胞移植可明显提高完全缓解肿瘤患者的治愈率;对于复发或难治者,可以提高完全缓解率,延长生存期,提高生活质量。
Objective To investigate the efficacy of autologous hematopoietic stem cell transplantation (AHSCT) in the treatment of hematologic malignancies and solid tumors. Methods A total of 20 patients with leukemia and malignant lymphoma treated with AHSCT at the First Affiliated Hospital of Guangzhou Medical College from May 1996 to February 2005 were aged 18 to 50 years. Pretreatment chemotherapy regimens selected any combination of any two or three of the following drugs: cytarabine 3 ~ 4g / m2, cyclophosphamide 4 ~ 6g / m2, etoposide (VP- 16) 0.5 ~ 1.0g / m2, Simvastatin 300mg / m2, melphalan 140mg / m2, cetirizine 600mg / m2, carboplatin 1.0g / m2, busulfan (Bu) 16mg / kg. In addition to 2 cases of ALL combined with systemic irradiation (dose of 8Gy), the rest were chemotherapy alone. Results All patients underwent hematopoietic reconstitution after transplantation. No graft-related death occurred. All the patients were followed up for a median of 39.5 months (range 2-109 months). Fifteen cases were disease-free, accounting for 75.0% of all cases. One disease-free survival in 12 cases (60%), 2 years in 8 cases (40%), 3 years in 8 cases (40%), the longest survival of more than 9 years. Conclusion Autologous hematopoietic stem cell transplantation can significantly improve the cure rate of patients with complete remission. For relapsed or refractory patients, the complete remission rate, prolongation of survival and quality of life can be improved.