摘要：目的評價自體造血干細胞移植(AHSCT)治療惡性血液病的療效。方法用AHSCT治療白血病及惡性淋巴瘤患者共58例,年齡31.9±10.5(14~58)歲。其中急性非淋巴細胞白血病(ANLL)30例(CR-1 24例,CR2 5例,CR3 1例),急性淋巴細胞白血病(ALL)18例(CR1 13例,CR2 3例,CR3 2例),慢性粒細胞白血病(CML)3例(均獲血液學緩解),惡性淋巴瘤7例(CR 4例,PR 3例)。預處理化療方案選用以下藥物中任意兩種或三種聯合:阿糖胞苷3~4 g/m2,環磷酰胺4~6 g/m2,鬼臼乙叉苷(VP-16)0.5~10 g/m2。除5例聯合全身骨髓照射(劑量為7~8 Gy),其余均單用化療。結果所有患者移植后均重建造血,移植相關死亡1例(1.72%).ANLL、ALL CR1期移植者3年無病生存率分別為52.4%±4.2%和46.1%±3.5%,復發率分別為37.7%±4.5%和40.5%±6.7%。10例CML和惡性淋巴瘤患者中,除1例Ⅳ期惡性淋巴瘤患者復發,余均獲持續完全緩解。結論為降低白血病和惡性淋巴瘤的復發率,提高患者的無病生存期,無造血干細胞供者的CR1期白血病及惡性淋巴瘤患者應積極行AHSCT。%Objective To evaluate the therapeutic effect of autologous hematopoietic stem cell transplantation(AHSCT) on malignant hematopathy.Methods From December of 1989 to November of 1999, 58 patients with median age of 31.9±10.5 (14~58) years received AHSCT, 30 of them were acute non-lymphoblastic leukemia(ANLL)(CR1 24, CR2 5, CR3 1), 18 were acute lymphoblastic leukemia(ALL)(CR1 13, CR2 3, CR3 2), 3 were chronic myelogenous leukemia(CML,all acquired hemato logically complete remission ) and 7 were malignant lymphoma(4 of CR, 3 of PR). 2 or 3 of following agents: Ara-C 3~4 g/m2, CTX 4~6 g/m2 and VP-16 0.5~1.0 g/m2, were combined as conditioning regimen in all patients. Among them 5 patients accepted additional total body bone marrow irradiation.Results All the patients have reconstituted bone marrow hematopoiesis after transplantation. The transplantation-related mortality rate was 1.72％(one case). The 3-year disease-free survival rates of ANLL and ALL at CR1 stage were 52.4%±4.2％ and 46.1%±3.5％ respectively, and the relapse rate were 37.7%±4.5％ and 40.5%±4.6％ respectively. Among 10 patients with CML and malignant lymphoma, 9 achieved continuous complete remission(CCR) except that one case of Ⅳ stage lymphoma relapsed.Conclusion Without compatible donors, patients with leukemia and malignant lymphoma at CR1 stage could receive AHSCT to reduce relapse and increase disease-free survival.
