时辰高剂量化疗联合自体骨髓移植治疗非霍奇金淋巴瘤的长期随访

目的　探讨在自体骨髓 (造血干细胞 )移植技术支持下应用时辰高剂量的环磷酰胺、足叶乙甙、阿糖胞苷和表阿霉素等组成 COAE预处理化疗方案治疗预后差的中高度恶性非霍奇金淋巴瘤 (NHL )的疗效。方法　观察 11例 NHL患者应用该项治疗后造血与免疫功能重建、长期无病生存率、毒副作用及移植相关死亡等 ,选用COX回归模型分析性别、年龄、预处理方案、分期、移植时状态等对无病生存时间的影响。结果　所有患者均获得造血与免疫功能重建。随访 1、3、5年 ,无病生存率分别为 81.8%、6 3.6 %、5 4 .5 % ,最长存活 9年。 5例复发(4 5 .4 % )。无移植相关死亡。结论　该法在给药时间上进行了创新 ,提高了疗效 ,减低了高剂量化疗的毒副作用。该法作为有不良预后因素的中高度恶性 NHL患者诱导化疗达完全缓解后强化治疗手段的远期疗效显著 ,优于常规化疗 ,能够改善生存率

Long-term following of high-dose chronochemo-therapy with autologous bone marrow transplantation for non-Hodgkin's lymphoma

Objective To explore the reversing effect of high-dose chronochemotherapy, following autologous bone marrow transplantation (ABMT) on the patients with poor prognosis and intermediate or high-grade non-Hodgkin's lymphoma (NHL).Methods Eleven NHL patients were treated by high-dose chronochemotherapy,with cyolophosphamide,cytosine arabinoside,pharmorubicin and etoposide (COAE).The reconstitution of hematopoiesis and immunity was observed post-transplantation. The long-term survival, side effects and transplantation-related-death of all the patients were investigated.The factors influencing the disease-free-survival (DFS) were analyzed with COX regression model, which included sex, age, kinds of pathology, conditioning regimen, etc.Results All the patients were reconstituted hematopiesis and immunity. The 1, 3 and 5 years DFS rates in patients with NHL were 81.8%, 63.6% and 54.5% respectively,with the longest survival of 9 years.Five patients developed relapse.Conclusions The high-dose COAE regimen changes at chronochemotherapy, reduces the relapse and toxicity and increases the long-term-survival. Its long-term effect is significant for the patients with poor prognosis and intermediate or high-grade NHL after complete remission (CR).