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目的 探讨高剂量化疗并自体外周血干细胞移植治疗高危实体瘤的可行性及疗效 ,了解外周血干细胞动员及采集时机、造血功能重建等问题。方法 9例经病理组织学确诊的高危乳腺癌 2例 ,非霍奇金淋巴瘤 (NHL)3例及 4例小细胞肺癌经过诱导化疗后 ,进行了高剂量化疗并自体外周血干细胞的移植。结果 随访 7(1.6～13.8)个月 ,9例全部生存 ,7例无瘤生存。回输的单个核细胞 (MNC) >1.5× 10 8/kg时 ,中性粒细胞 (ANC)恢复≥0 .5× 10 9/L 和血小板 2 0× 10 9/L 所需的天数分别为 9天和 9.4天 ,无 1例骨髓功能重建不全。结论 高剂量化疗并自体外周血干细胞移植对化疗敏感的乳腺癌、NHL 及小细胞肺癌具有较好疗效且较安全 ,回输足够数量的造血干细胞 ,可使造血功能快速重建。
Objective To investigate the feasibility and efficacy of high-dose chemotherapy and autologous peripheral blood stem cell transplantation in the treatment of high-risk solid tumors and to understand the mobilization and collection of peripheral blood stem cells and the reconstruction of hematopoietic function. Methods Nine cases of high-risk breast cancer confirmed by histopathology, three cases of non-Hodgkin’s lymphoma (NHL) and four cases of small cell lung cancer were treated with high-dose chemotherapy and autologous peripheral blood stem cell transplantation after induction chemotherapy. Results All patients were followed up for 7 (1.6 ~ 13.8) months. All 9 patients survived and 7 patients survived without disease. The number of days required for recovery of neutrophils (ANC) ≥0.5 × 10 9 / L and platelets 2 × 10 9 / L at a single mononuclear cell (MNC)> 1.5 × 10 8 / kg transfusion was 9 days and 9.4 days, no case of bone marrow dysplasia. Conclusion High-dose chemotherapy combined with autologous peripheral blood stem cell transplantation is more effective and safer to chemotherapy-sensitive breast cancer, NHL and small cell lung cancer, and can return a sufficient number of hematopoietic stem cells for rapid reconstruction of hematopoietic function.