【摘要】 目的 探讨接受不同预处理方案(化疗加全身放疗和单纯化疗)自体造血干细胞移植患儿的毒副反应、造血功能恢复及疗效的不同。方法 14例随访超过1年患儿，其中预处理方案为化疗加全身放疗6例，单纯化疗8例，观察急性毒副反应、生长发育、造血功能恢复以及生存情况。结果 3年无病生存率：A组67%(4/6)，B组60%(3/5)；WBC>1.0×109/L、ANC>0.5×109/L 、PLT>20×109/L；恢复时间(天)分别为：A组(21±9)天、(24±11)天、(26±8)天，B组(18±7)天、(21±8)天、(22±12)天；急性相关毒性：黏膜反应发生率分别为A组84%和B组75%，A组中有Ⅱ级反应，并且有膀胱、腮腺反应；晚期反应：A组中部分病例发生身高生长减缓和内分泌功能异常，放射后白内障发生率为50%(3/6)。结论 两种方案疗效、移植后的造血功能恢复时间及急性相关副作用的发生率相近，但应用全身放疗的患儿有晚期影响发生。

    【关键词】 化疗；全身放疗；自体造血干细胞移植

    Comparison of two prepare regimens for autologous peripheral blood stem cell transplantation in children with malignant disease

    WANG Jian-wen, TANG Suo-qin, LV Shan-gen,et al.

    Department of Pediatrics, General Hospital of PLA, Beijing 100853, China

    【Abstract】 Objective To compare the toxicities and potential effectiveness of autologous peripheral blood stem cell (PBSC) infusion in children with malignant disease post strong chemotherapy with TBI and without TBI. Methods 6.5～8Gy total body irradiation plus CTX 50mg/kg×2 (group A, 6 cases) versus carboplatin(425mg/m2×4days), etoposide (338mg/m2×4days)and melphalan (70mg/m2×3days) or busulphan ( 1mg/ kg·6h×3days) and melphalan(140mg/m2)( group B, 8 cases) followed by autologous PBSC for consolidation treatment.Results The mean time for reaching a granulocyte count greater than 0.5 ×109/L and for a platelet count greater than 20×109 /L was : group A (24±11)days ,( 26±8)days; group B (21±8)days ,(22±12)days. The event-free survival was similar in both groups. The incidence of severe mucositis, cystitis, parotiditis,cataract, disorder of growth and endocrine in group A.Conclusion The outcome , the duration of neutropenia and thrombocytopenia, and the incidence of acute related toxicites was similar in these patients. In group A, chronic complications were found. ......