郑志海　廖丽昇　曲双　谢颖　陈碧云

[关键词] 非霍奇金淋巴瘤;BEAM方案;造血干细胞移植;自体

[中图分类号] R730.5          [文献标识码] B          [文章编号] 1673-9701（2021）22-0086-04

Clinical analysis of BEAM regimen pretreatment for autologous peripheral blood stem cell transplantation in treatment of non-Hodgkin′s lymphoma

ZHENG Zhihai   LIAO Lisheng   QU Shuang   XIE Ying   CHEN Biyun

Department of Hematology， Fujian Provincial Hospital， Fuzhou   350001， China

[Abstract] Objective To explore the clinical efficacy and safety of BEAM regimen pretreatment for autologous peripheral blood stem cell transplantation in the treatment of non-Hodgkin′s lymphoma. Methods A retrospective analysis of 28 patients with non-Hodgkin′s lymphoma received autologous peripheral blood stem cell transplantation in the Department of Hematology of Fujian Provincial Hospital from January 2016 to June 2019 was conducted. The classic BEAM pretreatment regimen was used：Carmustine 300 mg/m2（-6 d）， etoposide 200 mg/m2[（-5 d）-（-2 d）]， cytarabine 400 mg/m2 [（-5 d）-（-2 d）]， and melphalan 140 mg/m2（-1 d）. Results The bone marrow hematopoiesis was reconstructed in all patients after transplantation. After transplantation， the median time to achieve absolute peripheral blood neutrophil count （ANC） ≥0.5×109/L and platelet≥20×109/L was 12.0（9-22）d and 15.5（10-28） d， respectively.The main adverse events were bone marrow suppression， infection， diarrhea， oral mucositis and implantation syndrome. The median follow-up time was 35.4 （6-92）months， and the median survival time was 28.5 （11-84） months. The estimated 2-year overall survival （OS） was 84.3%， and the 2-year disease-free survival （DFS） was 83.6%. Conclusion BEAM regimen pretreatment for autologous peripheral blood stem cell transplantation has positive effect in the treatment of non-Hodgkin's lymphoma， with rapid hematopoietic reconstitution， high safety and low toxicity.

[Key words] Non-Hodgkin′s lymphoma; BEAM regimen; Hematopoietic stem cell transplantation; Autologous

侵襲非霍奇金淋巴瘤（Non-hodgkin lymphoma，NHL）是常见的血液系统恶性肿瘤，使用联合化疗可很大程度地改善患者的预后，然而仍有相当一部分患者缓解后复发或治疗无效，疗效相对较好的病理类型弥漫性大B细胞淋巴瘤，采用联合治疗也仍有约50%的患者病情复发。自体外周血造血干细胞移植（Autologous peripheral blood stem-cell transplantation，APBSCT）能最大程度上清除患者体内肿瘤细胞，已成为治疗侵袭性淋巴瘤的重要手段。为探索适宜的预处理方案，本研究对选用经典BEAM方案作为预处理方案序贯自体外周血造血干细胞移植治疗的28例NHL患者病历资料进行回顾性分析，现报道如下。

1 资料与方法

1.1 一般资料

回顾性分析2016年1月至2019年6月住院的28例NHL患者，中位年龄39.5（17～61）岁，其中男18例，女10例。所有患者均经病理组织学确诊，其中弥漫大B细胞淋巴瘤14例，滤泡性淋巴瘤1例，Burkitt淋巴瘤1例，套细胞淋巴瘤1例，B细胞源性淋巴瘤1例，间变大细胞性淋巴瘤4例，外周T细胞淋巴瘤2例，血管免疫母细胞性T细胞淋巴瘤2例，T淋巴母细胞淋巴瘤2例。其中1例弥漫大B细胞淋巴瘤和1例间变大细胞性淋巴瘤初诊时合并中枢神经系统浸润。所有患者移植前多采用ECHOP、RCHOP、RCHOPE、Hyper-CVAD-A/B、REPOCH、GDP+P-ASP等方案化疗;有3例患者移植前做过局部放疗;移植前评价达CR或接近CR者14例，达PR者14例。