發(fā)布時間：2018-03-19 23:28

  本文選題：造血干細胞移植　切入點：非霍奇金淋巴瘤　出處：《廣西醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:回顧性分析造血干細胞移植治療非霍奇金淋巴瘤的療效,并探討影響其預后的因素。方法:38例患者均為2002年至2016年間在廣西醫(yī)科大學第一附屬醫(yī)院接受造血干細胞移植的NHL患者,其中行自體造血干細胞移植15例,異基因造血干細胞移植23例,含全身照射(TBI)的患者30例,不含TBI患者8例。所有患者中,25例移植前達CR,13例移植前未達CR。自患者移植時間起,研究終止時間為患者死亡或末次隨訪時間。結果:存活患者的中位隨訪時間為69.5(4-136)個月,所有患者均獲得造血重建,38例NHL患者移植后的3年OS率為52%,3年PFS率為50.7%。移植前達到CR與未達CR患者的3年OS率分別為65.7%、26.9%(P=0.03),3年PFS率分別為64.7%、23.9%(P=0.01)。Auto-HSCT與Allo-HSCT移植患者的3年OS率分別為72.2%、39%(P=0.12)。單因素分析示移植前疾病狀態(tài)、IPI評分為影響預后的因素。多因素分析結果則顯示移植前疾病狀態(tài)為影響患者OS及PFS的獨立預后因素。結論:造血干細胞移植是治療NHL的有效方法。移植前未能達到完全緩解狀態(tài)為影響預后的獨立危險因素,因此,在完全緩解期進行造血干細胞移植可獲得較好的OS率及PFS率。
[Abstract]:Objective: to retrospectively analyze the efficacy of hematopoietic stem cell transplantation in the treatment of non-Hodgkin 's lymphoma. Methods from 2002 to 2016, 38 patients with NHL received hematopoietic stem cell transplantation in the first affiliated Hospital of Guangxi Medical University, 15 of them received autologous hematopoietic stem cell transplantation. Allogeneic hematopoietic stem cell transplantation (HSCT) was performed in 23 patients, including 30 patients with TBI and 8 patients without TBI. Results: the median follow-up time for surviving patients was 69.54-136 months. All patients received hematopoietic reconstitution. The 3-year OS rate of 38 NHL patients with hematopoietic reconstitution was 522.The 3-year PFS rate was 50.7. The 3-year OS rate of CR patients before transplantation and that of non-CR patients was 65.726.9%, and the 3-year PFS rate was 64.7% (P 0.01 .Auto-HSCT), respectively, and the 3-year OS rate of Allo-HSCT patients was higher than that of Allo-HSCT patients (P 0.01 .Auto-HSCT). The results of multivariate analysis showed that the state of disease before transplantation was an independent prognostic factor for patients with OS and PFS. Conclusion: hematopoietic stem cells are independent prognostic factors of hematopoietic stem cells. Transplantation is an effective method for the treatment of NHL. Failure to achieve complete remission before transplantation is an independent risk factor for prognosis. Therefore, hematopoietic stem cell transplantation at complete remission stage can obtain better OS rate and PFS rate.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R733.1

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本文編號：1636531