DA-EPOCH化疗联合G-CSF有效动员非霍奇金淋巴瘤患者自体外周血造血干细胞

发布时间：2018-11-06 10:41

【摘要】：目的:探讨CTX+G-CSF和DA-EPOCH+G-CSF方案对非霍奇金淋巴瘤(NHL)患者外周血干细胞动员采集及造血恢复的效果。方法:回顾性分析我科收治的40例NHL患者分别采用CTX+G-CSF及DA-EPOCH+GCSF方案进行外周血造血干细胞(PBSC)动员、采集,并予BEAM方案预处理后回输自体外周血干细胞,分析动员效果、不良反应及自体移植后造血恢复情况。结果:CTX+G-CSF组动员期间1例患者外周血白细胞(WBC)计数降至0.8×10~9/L,其余WBC数最低值均2.0×10~9/L,3例血小板数降至80×10~9/L左右,其余患者血小板数均正常,单次采集物CD34~+细胞比例中位数0.99(0.35-1.30)%,共采集单个核(MNC)数(3.80±2.05)×10~10~,累计MNC(5.84±2.48)×10~8/kg,CD34~+细胞数中位数3.84(3.91-6.5)×10~6/kg。DA-EPOCH+G-CSF组动员期间患者外周血白细胞(WBC)计数最低降至(0.2-1.4)×10~9/L,1例血小板(Plt)数最低为8×10~9/L,其余均在40×10~9/L以上,单次采集物CD34~+细胞比例中位数0.85(0.34-1.2)%,共采集MNC中位数(3.68±1.56)×10~(10),累计MNC数(6.01±2.26)×10~8/kg,CD34~+细胞数中位数4.44(2.7-7.10)×10~6/kg。2组患者采集物CD34~+细胞比例中位数、总MNC中位数,累计每公斤体重MNC数及CD34~+细胞数中位数比较无统计学差异(P0.05)。CTX+G-CSF组自体干细胞移植后粒细胞植活平均时间为10.00(9.00-11.00)d,血小板植活平均时间为12.00(11.00-13.50)d;DA-EPOCH组自体干细胞移植后粒细胞植活平均时间为10.00(9.00-11.00)d,血小板植活平均时间为12.50(11.00-17.25)d,2组比较无统计学差异(P0.05),在移植过程中无死亡病例。结论:DA-EPOCH联合G-CSF方案可有效动员NHL患者的外周血干细胞,安全性高,且经济实惠,值得临床推广
[Abstract]:Objective: to investigate the effect of CTX G-CSF and DA-EPOCH G-CSF regimen on peripheral blood stem cell mobilization and hematopoietic recovery in (NHL) patients with non Hodgkin's lymphoma. Methods: a retrospective analysis of 40 patients with NHL treated in our department was performed with CTX G-CSF and DA-EPOCH GCSF regimen to mobilize and collect peripheral blood hematopoietic stem cells (PBSCs), and the autologous peripheral blood stem cells (PBSCs) were pretreated with BEAM regimen and then infused with autologous peripheral blood stem cells. The mobilization effect, adverse reaction and hematopoietic recovery after autologous transplantation were analyzed. Results: during mobilization in CTX G-CSF group, the leukocyte (WBC) count in peripheral blood of one patient decreased to 0.8 脳 10 ~ (9) / L, the lowest value of other WBC was 2.0 脳 10 ~ (9) 路L ~ (-1) / L, the platelet count of 3 cases decreased to about 80 脳 10 ~ (9) / L, and the platelet count of other patients was normal. The median percentage of CD34~ cells in a single sample was 0.99 (0.35-1.30)%. The number of mononuclear (MNC) was (3.80 卤2.05) 脳 10 ~ (10) ~ (10) and the cumulative MNC was (5.84 卤2.48) 脳 10 ~ (10) ~ (8) 路kg ~ (-1) 路kg ~ (-1). The median number of CD34~ cells in 3.84 (3.91-6.5) 脳 10~6/kg.DA-EPOCH G-CSF group decreased from (0.2-1.4) 脳 10 ~ (9) L to (0.2-1.4) 脳 10 ~ (9) L during mobilization. The lowest number of platelet (Plt) was 8 脳 10 ~ 9 / L, the rest were above 40 脳 10 ~ (9) / L, the median of CD34~ cells was 0.85 (0.34-1.2)%, and the median of MNC was (3.68 卤1.56) 脳 10 ~ (10). Cumulative MNC number (6.01 卤2.26) 脳 10 ~ (-1) 脳 10 ~ (-1) 路kg ~ (34) ~ median of CD34 ~ cells. Median percentage of CD34~ cells and median of total MNC were 4.44 (2.7-7.10) 脳 10~6/kg.2. There was no significant difference in cumulative MNC number and median number of CD34~ cells per kg body weight (P0.05) the mean time of granulocyte implantation was 10.00 (9.00-11.00) days after autologous stem cell transplantation in). CTX G-CSF group. The mean time of platelet transplantation was 12.00 (11.00-13.50) days. The mean time of autologous stem cell transplantation was 10.00 (9.00-11.00) days in DA-EPOCH group, and the mean time of platelet transplantation was 12.50 (11.00-17.25) days after autologous stem cell transplantation (P0.05). There were no deaths during the transplant. Conclusion: DA-EPOCH combined with G-CSF regimen can effectively mobilize peripheral blood stem cells from NHL patients. It is safe, economical and worthy of clinical popularization.
【作者单位】：福建医科大学省立临床医学院福建省立医院血液科;
【分类号】：R733.1

【相似文献】