Abstract:

BACKGROUND: Peripheral blood stem cell (PBSC) transplantation in combination with bone marrow-derived mesenchymal stem cell (BMSC) transplantation may minimize hematopoietic reconstruction delay or failure caused by hemopoietic microenvironment damage.
OBJECTIVE: To investigate the safety and effect of BMSC+ PBSC transplantation in the treatment of non-Hodgkin lymphoma.
METHODS: Two patients diagnosed as non-Hodgkin lymphoma were treated with chemotherapy for 5 or 6 cycles using R-CHOP protocols (rituximab, cyclophosphamide, Oncovin, and prednisone). BMSCs from autologous bone marrow were cultured prior to autologous PBSC mobilization using cyclophosphamide, granulocyte colony-stimulating factor or rituximab, cyclophosphamide, and granulocyte colony-stimulating factor. Preconditioning protocols used rituximab, cyclophosphamide, etoposide or rituximab, cyclophosphamide, liposome adriamycin, and dexamethasone. Mononuclear cells of 2.98×10⁶/kg, 3.84×10⁸/kg and BMSCs of 3.8×10⁶/kg, 3.96×10⁶/kg were infused.
RESULTS AND CONCLUSION: In case 1, the white blood cells decreased to the lowest level, 0.1×10⁹/L, neutrophil, 0×10⁹/L, 10 days following transplantation, and the platelet reduced to the minimal level of 45×10⁹/L up to 12 days. Peripheral blood restored to normal at 15 days after transplantation. The white blood cells and platelet reduced to the lowest levels up to 5 days following transplantation in case 2 and the peripheral blood restored to normal at 9 days. Transplantation-related complications included acute upper respiratory tract infection and external hemorrhoid infection, which were controlled by treatment. Results indicated that in the treatment of malignant lymphoma, autologous BMSC+ PBSC transplantation rapidly reconstructed hematopoiesis, and the tumor or swollen lymph node disappeared. The short-term effects were evident, but the long-term effect requires further investigation.