Analysis Of Therapeutic Effect Of CY-fTBI And BMM Conditioning Regimen In The Process Of Allo-HSCT Treating Ⅲ, Ⅳ Non-hodgkin Lymphoma

Objective:To investigate the effica CY of allogeneic hematopoietic stem cell transplantation(allo-HSCT) in the treatment of patients with III, IV non-Hodgkin lymphoma(NHL), and compared the effica CY between CY-fractionated to talbody irradiation(f TBI) based conditioning regimen and Maryland, horse flange and mitoxantrone(BMM)Methods:The clinical data of 47 patients with III, IV NHL after allo-HSCT in our center hospital from November 1998 to May 2014 were collected and retrospectively analyzed. To observe the hematopoietic reconstruction recovery after transplantation, cumulative incidence of acute graft-versus-host-disease(a GVHD) and chronic graft-versus-host-disease(c GVHD), transplantation related mortality(TRM), recurrence rate(RR), disease-free survival(DFS), overall survival(OS). Compare the effica CY of f TBI and BMM conditioning regimen at the same time.Results: Neutrophils achieving 0.5×109/L and platelets achieving 50×109/L on day 17(range,10~72,) post transplantation. Acute GVHD occurred in 53.19%, among them, grade I~II occurred in 42.55%, grade III~Ⅳ occurred in 10.65%, and c GVHD occurred in 21.28%. 21 patients were alive with a median follow up of 9.7 months(0.2-149.1 months), 17 patients have disease-free survival more than 4 years. Overall survival(OS) was 73.5%, 49.3%, 40.1% respectively in the first, third and fifth year in CY-f TBI group; in BMM group it was 67.8%, 32.9% and 31.4% respectively, and disease-free survival(DFS) was 5.3%, 45.6%, 30.2% respectively in the first, third and fifth year. In CY-f TBI group, the recurrence rate(RR)and transplantation related mortality(TRM) in the first year were 18.9%, 23.0% respectively, the third year were 19.5%, 38.3% and the fifth year were 35.2%, 39.2%. In BMM group, RR and TRM in the first year were 27.4%, 24.5% respectively, the third year were 38.9%, 46.4% and the fifth year were 39.2%, 48.2%. However, there is no significant difference in the indicator of OS, DFS, RR, TRM in the two groups.Conclusion: Allo-HSCT can make some Ⅲ, Ⅳ NHL patients achieve long-term disease-free survival, but the TRM is still high relatively. Moreover, compared with the program of BMM conditioning regimen, CY-f TBI may reduce the TRM and RR, meanwhile, increase the DFS and OS. However, due to the small number cases of two groups, we cannot find the statistical significant difference.