[1]杨懿春,岑雪波,罗小华,等.CEAC预处理后行自体造血干细胞移植对非霍奇金淋巴瘤患者的疗效评价[J].第三军医大学学报,2019,41(23):2272-2279.
 YANG Yichun,CEN Xuebo,LUO Xiaohua,et al.Efficacy of CEAC regimen before autologous hematopoietic stem cell transplantation for non-Hodgkin lymphoma: analysis of 102 cases[J].J Third Mil Med Univ,2019,41(23):2272-2279.
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CEAC预处理后行自体造血干细胞移植对非霍奇金淋巴瘤患者的疗效评价(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
41卷
期数:
2019年第23期
页码:
2272-2279
栏目:
专题报道
出版日期:
2019-12-15

文章信息/Info

Title:
Efficacy of CEAC regimen before autologous hematopoietic stem cell transplantation for non-Hodgkin lymphoma: analysis of 102 cases
作者:
杨懿春岑雪波罗小华王欣唐晓琼肖青张红宾陈建斌刘林王利
400016 重庆,重庆医科大学附属第一医院血液内科
Author(s):
YANG Yichun CEN Xuebo LUO Xiaohua WANG Xin TANG Xiaoqiong XIAO Qing ZHANG Hongbin CHEN Jianbin LIU Lin WANG Li

Department of Hematology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China

关键词:
自体造血干细胞移植非霍奇金淋巴瘤CEAC预处理方案
Keywords:
autologous hematopoietic stem cell transplantation non-Hodgkin lymphoma CEAC conditioning regimen
分类号:
R181.32; R730.59; R733.4
文献标志码:
A
摘要:

目的评价CEAC预处理方案(洛莫司汀、依托泊苷、阿糖胞苷及环磷酰胺)联合自体造血干细胞移植(autologous hematopoietic stem cell transplantation,auto-HSCT)治疗非霍奇金淋巴瘤患者的临床效果及不良反应。方法回顾性分析本院2011-2017年以CEAC方案预处理治疗后行auto-HSCT的102例非霍奇金淋巴瘤患者资料,进行生存因素分析,观察临床疗效、中性粒细胞及血小板重建时间、预处理相关毒性的发生情况。结果100例(98.0%)患者造血重建成功,中性粒细胞中位植入时间10(7~17)d,血小板中位植入时间12(7~33)d。恶心呕吐、发热、感染、肝脏毒性及腹泻为主要不良反应。中位随访时间42个月,25例(24.5%)出现疾病进展,18例(17.6%)死亡,其中9例(8.8%)因疾病进展死亡;3年总生存率为81.3%,3年无进展生存率为77.5%。单因素分析显示疾病类型是总生存率(P<0.001)和无进展生存率(P<0.001)的预后因素,IPI评分是无进展生存率(P=0.041)的预后因素;多因素分析显示疾病类型(HR=0.144,95%CI 0.052~0.400,P<0.001)是总生存率的独立预后因素,同时疾病类型(HR=0.291,95%CI 0.133~0.637,P=0.002)和移植前状态(HR=1.940,95%CI 1.192~3.159,P=0.008)是无进展生存率的独立预后因素。预处理相关毒性以恶心呕吐、腹泻、发热和感染发生率较高,移植相关病死率为1.96%。结论CEAC预处理方案对非霍奇金淋巴瘤患者行auto-HSCT具有较好的疗效和可接受的不良反应。

Abstract:

ObjectiveTo investigate the clinical efficacy and adverse reactions of CEAC conditioning regimen combined with autologous hematopoietic stem cell transplantation for treatment of non-Hodgkin lymphoma. MethodsWe conducted a retrospective analysis of 102 patients with non-Hodgkin lymphoma, who underwent autologous hematopoietic stem cell transplantation after CEAC conditioning regimen in our hospital from 2011 to 2017. The factors affecting the patients’ survival, clinical efficacy of the treatment, neutrophil and platelet reconstitution time, and adverse events associated with the conditioning regimen were analyzed. ResultsHematopoietic reconstruction was achieved successfully in 100 of the 102 patients. The median time of neutrophil and platelet reconstitution time was 10 d (7~17 d) and 12 d (7~33 d) in these cases, respectively. The main adverse reactions included nausea, vomit, fever, liver toxicity and diarrhea. The patients were followed up for a median of 42 months, during which disease progression occurred in 25 (24.5%) cases; death occurred in 18 (17.6%) cases, and 9 (8.8%) of these cases resulted from disease progression. The overall 3-year survival rate of the patients was 81.3%, with an overall 3-year progression-free survival rate of 77.5%. Univariate analysis showed that the disease type was a prognostic factor for the overall survival (P<0.001) and progression-free survival (P<0.001), and IPI score was a prognostic factor for progression-free survival (P=0.041). Multivariate analysis showed that the disease type (HR=0.144, 95%CI: 0.052~0.400, P<0.001) was an independent prognostic factor for the overall survival; the disease type (HR=0.291, 95%CI: 0.133~0.637, P=0.002) and the pretransplant status (HR=1.940, 95%CI: 1.192~3.159, P=0.008) were independent prognostic factors for progression-free survival. The toxic reactions related with the conditioning regimen included nausea, vomiting, diarrhea, fever, and infections, and the transplant-related mortality rate was 1.96%. ConclusionCEAC conditioning regimen can achieve a good efficacy with tolerable adverse reactions in patients undergoing autologous hematopoietic stem cell transplantation for non-Hodgkin lymphoma.
 

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更新日期/Last Update: 2019-12-09