自体造血干细胞移植治疗Ⅳ期神经母细胞瘤疗效分析
廉红云;王彬;周翾;马晓莉;张永红;朱光华;杨骏;秦茂权
【期刊名称】《中国小儿血液与肿瘤杂志》 【年(卷),期】2011(016)004
【摘要】目的 对以CEM(卡铂+依托泊苷+马法兰)为预处理方案的自体外周血造血干细胞移植术治疗20例Ⅳ期神经母细胞瘤患儿的疗效及不良反应进行评价.方法 2007年5月-2009年11月我科收治的Ⅳ期神经母细胞瘤患儿20例,中位年龄4.3岁(1.8～8.7岁),中位体重15.5 kg(9-22.5 kg);原发灶4例为纵隔,16例为肾上腺.14例患儿存在骨髓转移.5例经强化疗、手术减积治疗后仍存在残留病灶,为带瘤移植.预处理方案为CEM方案.结果 移植后中位随访时间为17.35个月(2～36个月),1例失访,带瘤移植组(n=5)中3例死亡,1例颅内复发放疗后仍存活,1例无疾病进展存活.移植前完全缓解组(n=15)随访14例,4例死亡,8例无疾病进展存活,2例复发仍存活.回输的CD34+细胞中位数为5.346(1.54～10.3)×106/kg,全部患儿移植后均获得造血重建,在骨髓空巢期均出现发热,4例出现败血症,致病菌分别为少酸链球菌、近平滑念珠菌、大肠埃希菌、表皮葡萄球菌感染,经抗感染治疗后痊愈.髓外毒性包括:18例Ⅱ度肝功能损害,16例Ⅰ度口腔黏膜炎,13例Ⅰ度腹泻,5例Ⅱ度腹泻,2例Ⅰ度心脏不良反应.无移植相关性死亡.结论 自体外周血造血干细胞移植术对移植前达到完全缓解的Ⅳ期神经母细胞瘤患儿有较好疗效,对部分缓解期患儿可提高缓解率,不良反应可逆,耐受性可.%Objective To investigate the clinical effects and toxicity of patients treated with CEM conditioning regimen combined with autologous peripheral blood stem cell transplantation in high-risk stage
Ⅳ neuroblastoma of childhood.Methods Twenty patients with high-risk neuroblastoma were treated in our hospital from May of 2007 to November of 2009.The median age was 4.3 years old.Primary sites of the tumors included mediastinum ( n = 4 ), and adrenal gland ( n = 16).Fourteen patients had bone-marrow metastases.Fifteen patients got CR (complete remission) while 5 patients had tumor residual disease after intensive induction therapy with 7 cycles and resection of the primary tumor before ASCT.All the 20 patients received autologous peripheral blood stem cell transplantation.The conditioning regimen consisted of melphalan, etoposide and carboplatin.Results With a median follow-up of 17.35 months, one of the patients were lost to follow-up.In the subgroup of patients ( n = 5) who had tumor residual disease before ASCT,three patients died and 1 patient suffered tumor recurrence ;in the subgroup of patients got CR ( n = 14 ), 4 patients died, 8 patients live without recurrence and 2 patients suffered recurrence but still alive.All the patients recovered from bone marrow suppression, the non-hematologic toxicity included liver function damage, oral mucositis, diarrhea and cardiac toxicity.All the 20 patients had febrile neutropenia and 4 had septicemia.Conclusion For patients who had CR before transplantation,high-dose chemotherapy combined with autologous peripheral stem cell transplantation achieved good outcome in patients with high risk stage Ⅳ neuroblastoma.The outcome of patients with
tumor residual disease could be improved by ASCT.Transplantation-related toxicities were tolerable. 【总页数】5页(164-168)
【关键词】神经母细胞瘤;自体外周血干细胞移植;诱导化疗;儿童 【作者】廉红云;王彬;周翾;马晓莉;张永红;朱光华;杨骏;秦茂权
【作者单位】100045,首都医科大学附属北京儿童医院血液中心;100045,首都医科大学附属北京儿童医院血液中心;100045,首都医科大学附属北京儿童医院血液中心;100045,首都医科大学附属北京儿童医院血液中心;100045,首都医科大学附属北京儿童医院血液中心;100045,首都医科大学附属北京儿童医院血液中心;100045,首都医科大学附属北京儿童医院血液中心;100045,首都医科大学附属北京儿童医院血液中心 【正文语种】中文 【中图分类】 【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_journal-china-pediatric-blood-cancer_thesis/0201235912240.html 【相关文献】
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自体造血干细胞移植治疗Ⅳ期神经母细胞瘤疗效分析
