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目的评价全身照射（ＴＢＩ）加足叶乙甙（Ｖｐ１６）作为自体造血干细胞移植（ＡＨＳＣＴ）的预处理方案治疗非霍奇金淋巴瘤（ＮＨＬ）的疗效和安全性。方法２４例诱导治疗缓解的中高度恶性ＮＨＬ进行ＡＨＳＣＴ，其中２３例为首次缓解，１例为第３次缓解。自体骨髓移植（ＡＢＭＴ）１０例，自体外周血干细胞移植（ＡＰＢＳＣＴ）１４例，采用ＴＢＩ８００（７００～８５０）ｃＧｙ／Ｖｐ１６７５７（３２３～１１４０）ｍｇ／ｍ２作为预处理方案。结果中位随访２２．５（２～９２）个月，诱导治疗达完全缓解者ＡＨＳＣＴ后的１年无病生存率（ＤＦＳ）为８６７％（１３／１５），３年、５年、７年ＤＦＳ均为８００％（１２／１５），诱导治疗达部分缓解者移植后６６７％（４／６）获长期无病生存，ＡＨＳＣＴ前复发者无长期生存，全组无移植相关死亡。ＡＰＢＳＣＴ较ＡＢＭＴ可使造血功能快速重建。结论首程诱导治疗缓解的中高度恶性ＮＨＬ行ＡＨＳＣＴ可获得满意的临床疗效，ＴＢＩ／Ｖｐ１６是ＮＨＬ患者ＡＰＢＳＣＴ的一个安全有效的预处理方案。
Objective To evaluate the efficacy and safety of whole body irradiation (TBI) plus epinephrine (Vp16) as a preconditioning regimen for autologous hematopoietic stem cell transplantation (AHSCT) in the treatment of non-Hodgkin’s lymphoma (NHL). Methods Twenty-four patients with moderate-to-high-grade NHL induced by remission induction were subjected to AHSCT. Among them, 23 cases were first remission and 1 case was the third remission. 10 cases of autologous bone marrow transplantation (ABMT) and 14 cases of autologous peripheral blood stem cell transplantation (APBSCT) were treated with TBI800 (700-850) cGy/Vp-16757 (323-1140) mg/m2 as a pretreatment regimen. Results The median follow-up was 22.5 (2 to 92) months. The 1-year disease-free survival (DFS) after induction therapy for AHSCT was 86.7% (13/15), 3 years and 5 years. The 7-year DFS was 80.0% (12/15). After induction therapy, some patients with partial remission achieved 66.7% (4/6) of the disease after long-term disease-free survival. There was no long-term survival after relapse of AHSCT. The whole group had no transplantation. Related death. APBSCT can reconstruct hematopoietic function faster than ABMT. Conclusions AHSCT with moderate-to-high-grade NHL for remission induced by first-course induction therapy can achieve satisfactory clinical efficacy. TBI/Vp16 is a safe and effective pretreatment protocol for APBSCT in patients with NHL.