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背景:利妥昔单抗单用或联合CHOP方案化疗治疗CD20阳性非霍奇金淋巴瘤已取得较好疗效,非霍奇金淋巴瘤经自体造血干细胞移植治疗同样可以提高患者的疗效和生存率,而将两种方法联合的效果尚存在争论。目的:探讨自体造血干细胞移植联合利妥昔单抗对CD20阳性非霍奇金淋巴瘤的有效性。方法:对6例CD20阳性非霍奇金淋巴瘤Ⅳ期患者进行自体造血干细胞移植的同时,联合使用利妥昔单抗,分别于移植前给予2～4次,动员和预处理前后各2次,移植后每3个月维持治疗1次,利妥昔单抗用量为375mg/m2静滴。结果与结论:平均采集单个核细胞数为5.13×10-8/kg,CD34+细胞数为4.75×10-6/kg。6例患者自体造血干细胞移植后,造血功能均恢复顺利,中性粒细胞计数大于0.5×10-9L-1为移植后9～15d,血小板计数大于20×10-9L-1为移植后12～19d。6例患者在移植过程中均未发生出血性膀胱炎、间质性肺炎、巨细胞病毒感染和肝静脉阻塞等并发症。利妥昔单抗使用过程中,无发热、寒战、皮疹等不良反应发生。移植后6～32个月,患者均处于完全缓解状态。提示自体造血干细胞移植并利妥昔单抗治疗CD20阳性非霍奇金淋巴瘤是一种较好的方法,可维持治疗效果,有利于防止复发。
BACKGROUND: Rituximab alone or in combination with CHOP regimen has been effective in treating CD20-positive non-Hodgkin’s lymphoma. Non-Hodgkin’s lymphoma treated by autologous hematopoietic stem cell transplantation can also improve the efficacy and survival of patients , But the effect of combining the two methods is still debated. Objective: To investigate the efficacy of autologous hematopoietic stem cell transplantation combined with rituximab in CD20 positive non-Hodgkin’s lymphoma. Methods: 6 cases of CD20-positive non-Hodgkin’s lymphoma Ⅳ patients with autologous hematopoietic stem cell transplantation, combined with rituximab, were given 2 to 4 times before transplantation, mobilization and pretreatment before and after each 2 times , Treatment was maintained every 3 months after transplantation 1, the amount of rituximab 375mg / m2 intravenous infusion. RESULTS AND CONCLUSION: The average number of mononuclear cells collected was 5.13 × 10-8 / kg and the number of CD34 + cells was 4.75 × 10-6 / kg. 6 cases of autologous hematopoietic stem cell transplantation, hematopoietic function recovered smoothly, neutrophil count greater than 0.5 × 10-9L-1 9 ~ 15d after transplantation, platelet count greater than 20 × 10-9L-1 after transplantation for 12 ~ 19d. Six patients had no complications of hemorrhagic cystitis, interstitial pneumonia, cytomegalovirus infection and hepatic vein occlusion during the transplantation. Rituximab during use, no fever, chills, rashes and other adverse reactions. 6 to 32 months after transplantation, patients were in complete remission. Prompted autologous hematopoietic stem cell transplantation and rituximab treatment of CD20 positive non-Hodgkin’s lymphoma is a better way to maintain the therapeutic effect is conducive to preventing recurrence.