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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.doc

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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.doc
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DA-EPOCH G-CSF : CTX+G-CSF DA-EPOCH+G-CSF (NHL) : 40 NHL CTX+G-CSF DA-EPOCH+GCSF (PBSC) , BEAM , :CTX+G-CSF 1 (WBC) 9 /L, WBC 9 /L, 3 9 /L , , CD34 + 0.99 (0.35-1.30) %, (MNC) 1 0 , 8 /kg, CD34 + 3.84 (3.91-6.5) 6 /kg DA-EPOCH+G-CSF (WBC) (0.2- 9 /L, 1 (Plt) 9 /L, 9 /L , CD34 + 0.85 (0.34-1.2) %, MNC 10 , MNC 8 /kg, CD34 + 4.44 (2.7- 6 /kg 2 CD34 + MNC , MNC CD34 + (P>0.05) CTX+G-CSF 10.00 (9.00-11.00) d, 12.00 (11.00-13.50) d;DA-EPOCH 10.00 (9.00-11.00) d, 12.50 (11.00-17.25) d, 2 (P>0.05) , :DA-EPOCH G-CSF NHL , , , ; DA-EPOCH ; DA-EPOCH+G-CSF; ; , .E-mail:liaolisheng@126.com DA-EPOCH Chemotherapy Combined with G-CSF Effectively Mobilizes Autologous PBHSC in NHL Patients LIAO Li-Sheng WEI Tian-Nan ZHENG Zhi-Hai QU Shuang XIE Ying WANG Zhi-Hong CHEN Bi-Yun Department of Hematology, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University; Abstract Objective: To study the effect of the DA-EPOCH chemotherapy combined with G-CSF and the CTX therapy with G-CSF on mobilizing and collecting the peripheral blood hematopoietic stem cells and the later hematopoietic recovery.Methods: Forty patients accepted mobilization and collection of peripheral blood stem cells ( PBSC) after treated by CTX +G-CSF and DA-EPOCH + G-CSF therapy respectively, and were treated by auto-transfusion after BEAM pre-regimen. The mobilization efficacy, adverse effects and hematopoietic recovery after autologous transplantation were analyzed retrospectively. Results: During the CTX + G-CSF mobilization, only one patient achieved the white blood cell ( WBC) 9 /L, while the others were with the lowest WBC level above 9 /L. The platelet counts were all normal with the exception of 9 /L. The median percentage of CD34 +cells in one period of collection was 0. 99 ( 0. 35- 10 8 /kg, and the median CD34 +cell count was 3. 84 ( 3. 91-6. 5) 6 /kg. During the DA-EPOCH + G-CSF mobilization, the peripheral WBC count of patients were decreased to the lowest level at ( 0. 2- 10 9 9 /L except for 1 case 9 /L. The median percentage of CD34 +cells in one period of collection was 0. 85 ( 0. 34-1. 2) %. The 10 . The cumulative total of mononuclear cells was ( 6 8 /kg, and the median CD34 +cell count was 4. 44 ( 2. 7- 6 /kg. There were no statistical differences between the 2 groups in the median percentage of CD34 +cells, the median MNC, the cumulative total of mononuclear cells and the median CD34 +cell counts ( P > 0. 05) . The average acquired time for granulocyte engraftment was 10. 00 ( 9. 00-11. 00) days, and for platelet engraftment was 12. 50 ( 11. 00-17. 25) days, with no statistical difference ( P > 0. 05) . No death occurred during the process of transplantation. Conclusion: DA-EPOCH therapy combined with G-CSF can effectively mobilize the peripheral blood hematopoietic stem cells in NHL patients with higher safety and lower price, and proves to be worth recommending in clinical use. Keyword non-Hodgkin's lymphoma; DA-EPOCH chemotherapy; DA-EPOCH + G-CSF; autologous peripheral blood stem cell mobilization; (autologous peripheral blood hematopoietic stem cell transplantation, Auto-PBHSCT) , , NHL [1] 2008 1 2016 6 40 NHL , CTX+G-CSF DA-EPOCH+G-CSF PBHSC , 2008 1 2016 6 40 NHL CTX+G-CSF 19 , 14 , 5 , (17-61) , 18 , / 1 ;B 10 ( B 6 , 1 , B 3 2 , 2 6 ) , T 9 ( 8 , / 1 2 7 ) ;2 , 11 B DA-EPOCH+G-CSF 21 , 14 , 7 , -58) , 18 , / 3 ;B 17 ( 14 , / 3 ; B 11 , 3 , B 3 1 7 9 ) , T 4 1 1 2 ) ;5 , 9 B PBHSC PBHSC 4 , B (375mg/m, 1 ) , CHOP ECHOP DA-EPOCH Hyper CVAD CTX+G-CSF 11 CR/Cru, 8 PR;DA-EPOCH 10 CR/CRu, 9 PR, 2 SD ( ) PBHSC CTX+G-CSF (CTX) 2 g/m 1 2 , 5-7 G-CSF 5- (kg.d) , 2 DA-EPOCH+G-CSF (EPI) 15 mg/m, (VP-16) 50 mg/m, 0.4 mg/m, 1-4 ; (CTX) 750 mg/m, 5 , 15 mg, 1-5 , 6-7 G-CSF 5- 2 PBHSC G-CSF 5-6 , >60 kg, WBC ; 0.05) ( 1 2) PBHSC CTX+G-CSF 1 WBC WBC , DA-EPOCH WBC (0.2- , 1 , CTX+G-CSF 5 , 4 (37.3- DA-EPOCH 8 , 1 , 3 , 7 (37.5- , 1 , 1 BEAM 48 h PBHSC, / CD34 93%-100%, , , CTX+G-CSF 8 , 8 , 1 , 2 , 2 d 10.00 (9.00-11.00) d, ( , 12.00 (11.00-13.50) d;DA-EPOCH 14 , 7 , 1 , 1 , 1 , 10.00 (9.00-11.00) d, 12.50 (11.00-17.25) d, (P>0.05) ( 1) , Table 1.Efficacy of peripheral blood hematopoietic stem cell mobilization and collection and average time of hematopoietic recovery after-transpla Table 2.Distribution of MNC and CD34cell (APBSCT) NHL (G-CSF) , CTX 4 g/m , , , , , , [2] , 80 , 1.6g/m 10 , 3 , 77 (96.25%) CD34 4 (1.59- 3 CD34 36.25% (29/80) , 23.75% (19/80) , [3] MOED ( 0.6 mg/kg 1-3 d; 2 mg 1 d; 10mg/kg 1-5 d; 10 mg 1-5 d) G-CSF 16 , 1-2 , MNC (2.0- (3.24- [4] 19 MAE [ ( 5d) ], PBHSC 1-3 , (6.1- (4.2- Lisenko [5] 65 B (DLBCL) , 63 (97%) CD34 Xia [6] 2004-2013 88 ICE/R-ICE G-CSF , 71 (80.7%) , CD34 5.46 (0.96- Wilson [7] , DA-EPOCH NHL , NHL Wilson [8] , 50 DLBCL EPOCH CR 92%, 5 70%, 5 73% [9] EPOCH T , CR 15 (45.5%) , PR 5 (15.2%) , RR 60.7% [10] 26 T (PTCL) , 92.3%, 61.5%, NCCN ( ) DA-EPOCH DLBCL PTCL 19 NHL CTX+G-CSF , , 1 WBC WBC , , , 2 , MNC 34 3.84 (3.91- BEAM 10.00 (9.00-11.00) d, 12.00 (11.00-13.50) d CTX+G-CSF , 2013 DA-EPOCH 6-7 G-CSF 5- G-CSF 5-6 85.7% (18/21) , 7 , , 1 , , MNC 4.44 (0.72- 2 CD34 MNC CD34 (P>0.05) , DA-EPOCH 1 61.9% (13/21) CTX 36.8% (7/19) DA-EPOCH 15 , 10.00 (9.00-11.00) d, 12.50 (11.00-17.25) d, CTX+G-CSF (P>0.05) , , , DA-EPOCH NHL , , , G-CSF , CTX+G-CSF , MNC , MNC CD34 , 1 (61.3% 36.8%) , , , , , [1] Schmitz N, Buske C, Gisselbrecht C.Autologous stem cell transplantation in lymphoma.Semin Hematol, 2007;44 (4) :234-245. [2] , , , . G-CSF . , 2012;22 (8) :628-631.
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本文标题: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.doc
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