造血干细胞移植治疗非霍奇金淋巴瘤的疗效分析

发布时间：2018-03-19 23:28

本文选题：造血干细胞移植　切入点：非霍奇金淋巴瘤　出处：《广西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:回顾性分析造血干细胞移植治疗非霍奇金淋巴瘤的疗效,并探讨影响其预后的因素。方法:38例患者均为2002年至2016年间在广西医科大学第一附属医院接受造血干细胞移植的NHL患者,其中行自体造血干细胞移植15例,异基因造血干细胞移植23例,含全身照射(TBI)的患者30例,不含TBI患者8例。所有患者中,25例移植前达CR,13例移植前未达CR。自患者移植时间起,研究终止时间为患者死亡或末次随访时间。结果:存活患者的中位随访时间为69.5(4-136)个月,所有患者均获得造血重建,38例NHL患者移植后的3年OS率为52%,3年PFS率为50.7%。移植前达到CR与未达CR患者的3年OS率分别为65.7%、26.9%(P=0.03),3年PFS率分别为64.7%、23.9%(P=0.01)。Auto-HSCT与Allo-HSCT移植患者的3年OS率分别为72.2%、39%(P=0.12)。单因素分析示移植前疾病状态、IPI评分为影响预后的因素。多因素分析结果则显示移植前疾病状态为影响患者OS及PFS的独立预后因素。结论:造血干细胞移植是治疗NHL的有效方法。移植前未能达到完全缓解状态为影响预后的独立危险因素,因此,在完全缓解期进行造血干细胞移植可获得较好的OS率及PFS率。
[Abstract]:Objective: to retrospectively analyze the efficacy of hematopoietic stem cell transplantation in the treatment of non-Hodgkin 's lymphoma. Methods from 2002 to 2016, 38 patients with NHL received hematopoietic stem cell transplantation in the first affiliated Hospital of Guangxi Medical University, 15 of them received autologous hematopoietic stem cell transplantation. Allogeneic hematopoietic stem cell transplantation (HSCT) was performed in 23 patients, including 30 patients with TBI and 8 patients without TBI. Results: the median follow-up time for surviving patients was 69.54-136 months. All patients received hematopoietic reconstitution. The 3-year OS rate of 38 NHL patients with hematopoietic reconstitution was 522.The 3-year PFS rate was 50.7. The 3-year OS rate of CR patients before transplantation and that of non-CR patients was 65.726.9%, and the 3-year PFS rate was 64.7% (P 0.01 .Auto-HSCT), respectively, and the 3-year OS rate of Allo-HSCT patients was higher than that of Allo-HSCT patients (P 0.01 .Auto-HSCT). The results of multivariate analysis showed that the state of disease before transplantation was an independent prognostic factor for patients with OS and PFS. Conclusion: hematopoietic stem cells are independent prognostic factors of hematopoietic stem cells. Transplantation is an effective method for the treatment of NHL. Failure to achieve complete remission before transplantation is an independent risk factor for prognosis. Therefore, hematopoietic stem cell transplantation at complete remission stage can obtain better OS rate and PFS rate.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R733.1

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