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POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes) syndrome is an extremely rare neurological disease exhibiting various symptoms. Few reports have investigated rehabilitation in this disease. The present study reported the details of rehabilitation in a 40-year-old man with POEMS syndrome. Abnormal sensation was initially observed in the distal legs, followed by deterioration of muscle strength. He was admitted to our hospital 2 months after onset and received high-dose chemotherapy with autologous peripheral blood stem cell transplantation for acute exacerbation of polyneuropathy. Electrophysiological examination revealed axonal neuropathy. Gradual improvement in muscle strength was observed after high-dose chemotherapy with autologous peripheral blood stem cell transplantation. He was able to walk with a knee-ankle-foot orthosis and crutches at the time of discharge, but he used a wheelchair for routine activities. He could ascend and descend stairs in his house with bottom shuffling. As it is difficult to predict the extent of ultimate improvement and timing of remission in this disease, it is important to devise a rehabilitation program from a long-term perspective and to aim at recovery of independence for daily living activities and social reintegration using supportive devices and compensatory methods.
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POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes) syndrome is an extremely rare neurological disease exhibiting various symptoms. Few reports have investigated rehabilitation in this disease. The present study reported the details of rehabilitation in a 40-year-old man with POEMS syndrome. Abnormal sensation was initially observed in the distal legs, followed by deterioration of muscle strength. He was admitted to our hospital 2 months after onset and received high-dose chemotherapy with autologous peripheral blood stem cell transplantation for acute exacerbation of polyneuropathy. Electrophysiological examination revealed axonal neuropathy. Gradual improvement in muscle strength was observed after high-dose chemotherapy with autologous peripheral blood stem cell transplantation. He was able to walk with a knee-ankle-foot orthosis and crutches at the time of discharge, but he used a wheelchair for routine activities. He could ascend and descend stairs in his house with bottom shuffling. As it is difficult to predict the extent of ultimate improvement and timing of remission in this disease, it is important to devise a rehabilitation program from a long-term perspective and to aim at recovery of independence for daily living activities and social reintegration using supportive devices and compensatory methods.
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Objective: To compare the efficacy between chemotherapy plus granulocyte colony-stimulating factor (G-CSF) and chemotherapy plus G-CSF and granulocyte-macrophage colony-stimulating factor (GM-CSF) for the mobilization of peripheral blood stem cells (PBSC) and hematopoietic recovery after transplantation in patients with multiple myeloma (MM). Methods: A retrospective study of autologous PBSC (APBSC) mobilization data of 56 MM patients who were treated with chemotherapy plus G-CSF or chemotherapy plus G-CSF and GM-CSF from May 2008 to July 2016 in Tianjin Medical University Cancer Institute and Hospital was conducted. The mobilization efficacy and hematopoietic recovery were analyzed. Results: In the univariate analysis, the successful collection rate of a single harvest in women and in patients with ISS stage Ⅲ and R-ISS stage Ⅱ/Ⅲ and treated with chemotherapy plus G-CSF was lower (P<0.05). However, age (≤60 years vs.>60 years), subtype, D-S staging (Ⅰ+Ⅱvs.Ⅲ), number of cycles of chemotherapy before mobilization (≤6 cycles vs.>6 cycles), disease phase before mobilization (PR vs. CR), and interval between diagnosis and mobilization (≤18 months vs.>18 months) were not correlated with CD34+ cell collection and successful mobilization rates (P>0.05). In the multivariate model, the successful mobilization rate in patients who received the chemotherapy plus G-CSF and GM-CSF mobilization regimen was higher (OR=12.009, 95% CI=1.961-73.537). The effect of mobilization regimens remained significant (P=0.007). Hematopoietic recovery without transplantation-related mortality occurred successfully in all patients. Conclusions: Chemotherapy plus G-CSF and GM-CSF mobilization regimens can significantly increase the effect of APBSC mobilization and ensure the recovery of hematopoietic function after transplantation. Chemotherapy plus G-CSF and GM-CSF mobilization regimens are safe and effective for mobilizing APBSCs.
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Objective:To compare the efficacy between chemotherapy with granulocyte colony-stimulating factor (G-CSF) and chemo-therapy with G-CSF and granulocyte-macrophage colony-stimulating factor (GM-CSF) for the mobilization of peripheral blood hemato-poietic stem cells and hematological recovery post-transplantation in patients with malignant lymphoma. Methods:Autologous pe-ripheral blood hematopoietic stem cell mobilization data of 61 malignant lymphoma patients who were treated with chemotherapy plus G-CSF or chemotherapy plus G-CSF and GM-CSF from May 2008 to October 2016 were included in this study. The mobilization effi-cacy and hematopoietic recovery were analyzed. Results:During mobilization, White blood cells (WBC) of all patients decreased to 1.0×109/L and platelets (PLT) dropped to 40×109/L. The successful mobilization rates of CD34+cell are 52.5%in chemotherapy plus G-CSF group and 90.5%in chemotherapy plus G-CSF+GM-CSF group (P=0.003). All patients successfully underwent hematopoietic recon-struction without transplantation-related mortality. Conclusion: Although chemotherapy with G-CSF+GM-CSF can significantly in-crease the effect of autologous peripheral blood hematopoietic stem cell mobilization, the reconstruction of hematopoietic function after transplantation and side reaction between the two groups are the same. Thus, chemotherapy with G-CSF+GM-CSF is not superior to chemotherapy with G-CSF in mobilizing autologous peripheral blood hematopoietic stem cells.
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Hepatoblastoma(HB) is the most common malignant hepatic tumor in the pediatric population,almost exclusively in infants and toddlers, which accounts for 50％ ～ 60％ of the liver tumors.Now, the comprehensive treatment program of HB in children includes surgery, chemotherapy, radiotherapy, and so on.Liver transplantation and autologous peripheral blood stem cell transplantation could also be applied to advanced or refractory hepatoblastoma in children.The high sensitivity of childhood hepatoblastoma to chemotherapeutic agents,makes chemotherapy as one of the main treatment modalities.This review mainly discusses chemotherapy treatment of HB in children.
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BACKGROUND: Autologous peripheral blood-stem cell transplantation (autoPBSCT) is the treatment of choice for hematologic malignancy, because the technique requires neither general anesthesia nor surgical intervention, amongst many other advantages. Despite these benefits, the risk of hematologic malignancy, as well as the effect of patient age and sex on the prediction of successful collection of autoPBSCT are still unclear. The purpose of this study was to examine whether the hematologic diagnosis of the disease, and age or sex affect the mobilization of CD34+ cells and mononuclear cells. METHODS: We retrospectively investigated 30 (6 multiple myeloma, 11 diffuse large B-cell lymphoma, 8 acute myeloid leukemia, 2 acute lymphoid leukemia, and 3 T-cell lymphoma) patients who underwent autoPBSCT between 2008 and 2011 at Daegu Catholic University Hospital. RESULTS: Patients with multiple myeloma had the highest average of both mononuclear cell (MNC) (2.07+/-0.67x10(8) cells/kg) and CD34+ cell (1.28+/-0.58x10(6) cells/kg) counts. Patients with T-cell lymphoma had both the lowest MNC (1.23+/-0.49x10(8) cells/kg) and CD34+ cell (0.20+/-0.6x10(6) cells/kg) counts. Male patients showed greater collected CD34+ cell counts (0.96+/-1.38x10(6) cells/kg) and MNC counts (1.71+/-0.76x10(8) cells/kg) than the female patients. Patients under the age of 44 had higher collected CD34+ cell counts (0.96+/-1.37x10(6) cells/kg) but lower counts of MNC (1.49+/-0.74x10(8) cells/kg). CONCLUSIONS: The collected MNC and CD34+ cell counts varied between the types of malignancies, and with respect to sex and age. However, only collected MNC counts were significantly different (P<0.05) among the different types of malignancies.
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Female , Humans , Male , Anesthesia, General , Autografts , Cell Count , Cell Transplantation , Diagnosis , Hematologic Neoplasms , Leukemia, Myeloid, Acute , Lymphoma, B-Cell , Lymphoma, T-Cell , Multiple Myeloma , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Retrospective Studies , Stem Cells , T-Lymphocytes , Transplantation, Autologous , TransplantsABSTRACT
POEMS syndrome is a rare clonal plasma cell disease characterized by polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes. Significant advances have been made in the diagnosis and treatment of POEMS syndrome over the last decade. In this study, we reviewed the diagnostic criteria and characteristic features of POEMS syndrome. We also focused on the role of the characteristic features of POEMS syndrome in early diagnosis. Autologous peripheral blood stem cell transplantation has become the first-line treatment for younger patients with normal organ function because it has resulted in a high response rate and durable remission. Melphalan and dexamethasone is an effective and well-tolerated treatment for older patients and those with organ dysfunction. Patients with poor performance status or renal function can benefit from novel agents that can also improve transplantation eligibility.
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Objective: To explore the value of high-dose therapy/autologous hematopoietic stem cell transplantation (HDT/AHSCT) in the treatment of patients with peripheral T-cell lymphoma (PTCL). Methods: The medical records of 50 patients with PTCL who received HDT/AHSCT were retrospectively analyzed. The followed-up was performed. Results: No HDT/AHSCT-related death occurred. The median follow-up time was 13 months (range: 1-136). The 2-year progression-free survival (PFS) and 2-year overall survival (OS) were 59.0% and 65.0%, respectively. Univariate analysis showed that the patients achieving complete remission (CR) before HDT/AHSCT had superior 2-year PFS and 2-year OS as compared with those of the patients not achieving CR (2-year PFS: 72.8% vs 41.9%, P = 0.003; 2-year OS: 88.2% vs 41.9%, P = 0.002). The 2-year PFS was 76.8% for the patients who were sensitive to the firstline treatment (CR1/PR1) as compared with 30.8% for the patients who were sensitive to the secondline treatment (CR2/PR2) (P = 0.001). The 2-year OS for patients achieving CR1/PR1was also much better than that for patients achieving CR2/PR2 (81.1% vs 46.2%, P = 0.015). Furthermore, Erythrocyte sedimentation rate (ESR) before transplantation was an important factor for 2-year PFS and 2-year OS (P = 0.004, P = 0.018). Serum lactate dehydrogenase (LDH) level before transplantation was another important factor for 2-year PFS (P = 0.044). Multivariate analysis showed that the therapeutic response (achieving CR) before transplantation was an independent factor for 2-year OS [risk ratio: 4.879 (95% confidence interval: 1.583-15.034), P = 0.006]. No independent factors for 2-year PFS were observed. Subgroup analysis revealed that the patients with angioimmunoblastic T-cell lymphoma and advanced natural killer (NK)/T-cell lymphoma who received HDT/AHSCT during first CR may have benefit in survival from HDT/AHSCT. Conclusion: HDT/AHSCT can be used as safe and effective first-line consolidation therapy or salvage therapy in patints with PTCL and partially improve the prognosis. Prospective randomized controlled trials are necessary to confirm the suitable pathologic subtype and the best pretransplantation status for HDT/AHSCT.
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Objective To investigate the causes of diarrhea during autologous peripheral blood stem cell transplantation (APBSCT )and summarize the nursing strategies.Method The histories of 23 APBSCT patients suffering from diarrheas were retrospectively reviewed to find out the causes of diarrhea and summarize the nursing strategies.Results The main causes of the diarrheas included the toxicity of pretreatment chemotherapy drugs in 15 cases,antibiotics in 2 cases,gastrointestinal motility drugs in 2 cases,intestinal infections from decreased immunity in 2 cases and other diseases in 2 cases,all recovered by corresponding managements.Conclusions APBSCT-associated diarrheas may be caused by chemotherapy drug toxicity,infections,drugs and other factors.So the nurses should evaluate them correctly,adopt corresponding nursing measures,strengthen the observation of patients' condition and raise awareness of prevention for the purpose of reducing the incidence of diarrhea,promoting the recovery of patients and improving the quality of life.
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Objective To investigate the effects of Porous tantalum rod implantation and autologous peripheral blood stem cell transplantation on the treatment of avascular necrosis of femoral head (ANFH).Methods Thirty-six cases with early ANFH (19 cases on the left side and 17 cases on the right side) treated by Porous tantalum rod implantation and matrix induced autologous peripheral blood stem cell trans-plantation from July 2009 to March 2011.The 36 cases had osteonecrosis of the femoral head(ONFH) lesions Ⅰ and Ⅱ according to the international bone circulation Research Association (ARCO) classification of ONFH lesion.All patients were followed up for 12-15 months.Clinical evaluation included preoperative and postoperative pain score,the Harris hip score,percentage of low signal MRI area in the volume of femoral head.Results All the patients were followed up for 12 to 15 months.The postoperative Harris hip score was significantly higher than pre-operation ((91.70 ± 6.90) vs.(68.32 ± 7.10) ; t =4.364,P ＜ 0.01).Pain symptoms reduced markedly ((15.55 ±6.60) vs.(29.78 ±5.67);t =3.423,P ＜0.05).Hip flexion and external rotation function was restored.MRI showed that after the operations the volume of areas with femoral head necrosis significantly reduced in compared with the pre-operation ((38.20 ± 8.30) ％ vs.(21.43 ± 5.10) ％ ; t =6.527,P ＜ 0.05).Conclusion Porous tantalum rod implantation and autologous peripheral blood stem cell transplantation can significantly reduce joint pain,dramatically restore joint function,effectively prevent collapse of the femoral head,retard progression and has good clinical efficacy in the treatment of early femoral head necrosis.
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Crow-Fukase syndrome is diagnosed by the presence of polyneuropathy in conjunction with several other characteristic generalized symptoms, including organomegaly, endocrinopathy, M protein, and skin changes (POEMS syndrome). Rehabilitation is very important for patients with Crow-Fukase syndrome because progressive polyneuropathy reduces a patient's muscle strength. We report a case of long-term rehabilitation after high-dose chemotherapy with autologous peripheral blood stem cell transplantation. After transplantation, neurologic improvement began, and following rehabilitation therapy, the patient's proximal lower extremity muscle strength recovered to an almost normal level. At 2 months after transplantation, the patient could walk again using a cane and an ankle-foot orthosis. At six and a half years after transplantation, the neuropathy was still improving and there was no recurrence of other symptoms. We suggest that rehabilitation combined with autologous peripheral blood stem cell transplantation for Crow-Fukase syndrome is very useful for improving the disuse condition and for recovering muscle strength.
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Objective To evaluate clinical effect of autologous peripheral blood stem cell transplantation(APBSCT)on the treatment of hematologic malignancies.Methods Totally 231 patients(ALL in 45 cases,AML in 34 cases,NHL in 100 cases,HD in 31 cases,MM in 21 cases)with hematologic malignancies received APBSCT from March 2001 to February 2007.Therapeutic effect and complication were oberserved.Results Totally 230 patients obtained hematopoietic reconstitution quickly,one case failed.ALL CR1(first time CR):13 in DFS,4 alive with disease(LWD),11 in death;ALL CR2(second time CR):3 in DFS,4 in LWD,10 in death;AML CR1:12 in DFS,3 in LWD,6 in death;AML CR2:6 in DFS,2 in LWD,6 in death;NHL CR:43 in DFS,7 in LWD,9 in death;NHL CR2:18 in DFS,5 in LWD,7 in death;NHL NR:2 in DFS,4 in LWD,5 in death;HD CR1:10 in DFS;HD PR:12 in DFS,3 in LWD;HD RE:3 in DFS,2 in LWD,1 in death;MM:7 in DFS,6 in LWD,8 in death.Conclusion APBSCT is a safe and effective therapy method for treating hematologic malignancies.
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Objective To study the changes of clonality of T cell receptor (TCR) and complementarity determinative region 3(CDR3) before and after autologous peripheral blood CD34+ stem cell transplantation(auto-PBSCT) for severe/refractory connective tissue disease(CTD). Methods Thirteen patients with severe/refractory CTD were enrolled for auto-PBSCT in Peking Union Medical College Hospital, including systemic lupus erythematosus (8 cases), rheumatoid arthritis(4 cases), and primary Sjogren’s Syndrome(1 case). Blood samples were collected before/after mobilization, 2 weeks, 1, 3, 6, 12 and 18 months post-transplantation. Diversity of TCRBV and CDR3 were showed by reverse transcription-polymerase chain reaction(RT-PCR) and genescan. Results The TCR BV usage and CDR3 spectral pattern of pre-auto-PBSCT CTD patients were revealed skewed pattern and oligoclonality, Which developed severe oligoclonality within 1 months after auto-PBSCT. However, they showed diversity andpoly-clonality 3～6 months after auto-PBSCT. Conclusion Skewed pattern and oligoclonality of TCRBV and CDR3 which implied auto-reactive were depressed after auto-PBSCT, and inclined to change to normal pattern.
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PURPOSE: Autologous stem cell transplantation (ASCT) is increasingly used in patients with non-Hodgkin's lymphoma (NHL). Various clinical parameters-were evaluated to obtain significant predictors of the outcome following ASCT in patients with NHL. MATERIALS AND METHODS: Between April 1994 and December 2003, ASCT was performed on 80 patients with NHL at the Asan Medical Center. RESULTS: Patients had various histological subtypes and disease status. The two year progression free survival (PFS) and overall survival for all patients were 34 and 31%, respectively. A univariate analysis showed the performance status, stage, modified extranodal involvement category, International Prognostic Index (IPI) at mobilization, disease status at mobilization, and history of radiation prior to mobilization as significant predictors of the outcome following ASCT. Four risk groups, with different 2 year PFS, were identified by the age adjusted IPI at mobilization (mAAIPI): low risk 44%; low intermediate risk 40%; high intermediate risk 19%; and high risk 0% (p=.0003). A multivariate analysis revealed 3 significant factors for the PFS: disease status, prior RT and mAAIPI. CONCLUSIONS: The mAAIPI was found to be an independent predictor of the outcome of NHL patients undergoing ASCT. This powerful prognostic tool should be used to evaluate potential candidates for ASCT.
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Humans , Disease-Free Survival , Hematopoietic Stem Cell Mobilization , Lymphoma, Non-Hodgkin , Multivariate Analysis , Prognosis , Stem Cell Transplantation , Stem CellsABSTRACT
Thrombotic thombocytopenic purpura (TTP) is a serious complication following stem cell trans-plantation (SCT). Although therapeutic plasma exchange offers an encouraging treatment modality in classic TTP, this does not appear to be effective in its management of TTP following SCT. This patient with malignant lymphoma developed TTP two months after autologous peripheral blood SCT and was effectively treated with plasma exchange and steroid therapy. Plasma exchange with fresh frozen plasma and albumin was performed 14 times in 40 days. Even though TTP may emerge as a complication of autologous peripheral blood SCT, this report suggests that the risk of developing TTP after autologous peripheral blood SCT may be low and a multiple course of plasma exchange may be an effective treatment in this patient.
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Humans , Lymphoma , Peripheral Blood Stem Cell Transplantation , Plasma , Plasma Exchange , Purpura , Purpura, Thrombotic Thrombocytopenic , Stem CellsABSTRACT
PURPOSE: Ewing sarcoma (ES) occurs mainly in the pediatric and adolescent population. We evaluated the clinical characteristics and the efficacy of treatment on ES in children who were treated at Seoul National University Children's Hospital. METHODS: We undertook a retrospective analysis of 12 patients diagnosed as ES between March, 1986 and December, 2002. Systemic chemotherapyregimens were as follows: CCG 731 (Vincristine, Adriamycin, Methotrexate, Actinomycin D, Cyclophosphamide; N=6), CCG 7881B (Ifosfamide, Etoposide, Vincristine, Adriamycin, Cyclophosphamide; N=2), POG-ICE (Ifosfamide, Etoposide, Carboplatin; N=1), CCG 7881B and BCD (Bleomycin, Cyclophosphamide, Actinomycin D; N=1), CCG 7881B, POG-ICE and VEC (Vincristine, Etoposide, Carboplatin; N=1). One case received CCG 7881B and autologous peripheral blood stem cell transplantation (PBSCT). RESULTS: Among the 12 patients, 8 patients were male and the others were female. The patients median age was 7 years 10 months. The primary tumors occurred in femur (N=4), pubis (N=2), vertebra (N=2) and clavicle, humerus, rib, phalanx one each. All patients were treated with systemic chemotherapy and the duration was median 13 months. Eight patients received radical surgery and nine patients received radiotherapy. Overall 5 years survival rate was 33.3% and one patient who received systemic chemotherapy and PBSCT is alive disease-free for more than 5 years. Eight patients who had more than one poor prognostic factor died. CONCLUSION: Though recent therapeutic trials led to improvement of survival in patients with ES, the prognosis for patient with high-risk disease remain poor and the treatment related toxicities are problem to solve. For the advanced or recurrent cases more intensive therapeutic modality such as autologous bone mallow transplantation or PBSCT should be considered.
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Adolescent , Child , Female , Humans , Male , Carboplatin , Clavicle , Combined Modality Therapy , Cyclophosphamide , Dactinomycin , Doxorubicin , Drug Therapy , Etoposide , Femur , Humerus , Methotrexate , Peripheral Blood Stem Cell Transplantation , Prognosis , Radiotherapy , Retrospective Studies , Ribs , Sarcoma, Ewing , Seoul , Spine , Survival Rate , VincristineABSTRACT
BACKGROUND: Recently, the use of peripheral blood stem cell (PBSC) instead of bone marrow stem cells is associated with faster engraftment and reduced transplantation related complications. Several studies revealed that intermediate dose of Granulocyte-Colony Stimulating Factor (G-CSF) (less than 5ng/kg) is enough to be effective in the mobilization of stem cells for autologous transplantation. Also, to simplify mobilization procedure and reduce the cost for mobilization, a fixed dose of G- CSF (250 ng/patient/day) needs to be tested for its clinical feasibility. METHODS: Patients with various malignant diseases were referred to the Ajou University Hospital (N=106) for PBSC transplantation with high dose chemotherapy. All patients were given fixed dose of G-CSF (250 ng/patient/ day) for mobilization and engraftment. RESULTS: Except for a few complaints of mild bone pain, all of the patients tolerated the treatment well during the mobilization. Early engraftment and yield of mobilization were related to the accumulated cycle of prior chemotherapy and prior radiotherapy. CONCLUSION: Fixed dose of G-CSF without accordance to the body weight of the patient showed no significant difference compared to the current reports on the mobilization of stem cells and engraftment after transplantation. The total number of chemotherapy cycles exposed before transplantation and the prior radiation therapy history were certainly the most important influencing factor in stem cell transplantation and mobilization.
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Humans , Autografts , Body Weight , Bone Marrow , Drug Therapy , Granulocyte Colony-Stimulating Factor , Radiotherapy , Stem Cell Transplantation , Stem Cells , Transplantation, AutologousABSTRACT
Familial hemophagocytic lymphohistiocytosis (FHL) is a fatal illness with a median life expectancy of 2 months if not treated. However, with the recent employment of allogeneic bone marrow transplantation in the treatment of FHL, even complete cure might be anticipated. We report here a case of prolonged remission following autologous peripheral blood stem cell transplantation (Auto-PBSCT) which was first attempted for FHL in Korea. A 4-month-old girl presented with high fever and a huge hepatosplenomegaly. Bone marrow examination revealed the proliferation of both non-malignant histiocytes engulfing red blood cells and lymphocytes. Her brother died at the age of 18 months showing quite similar manifestations. A diagnosis of FHL was made. Following 8 courses of chemotherapy with multiple drugs, Auto-PBSCT was performed. She has been well without any evidence of disease over 8 months of post- transplant period. This case illustrates that it might be worth trying Auto- PBSCT in the treatment of FHL.
Subject(s)
Female , Humans , Infant , Bone Marrow Examination , Bone Marrow Transplantation , Diagnosis , Drug Therapy , Employment , Erythrocytes , Fever , Histiocytes , Korea , Life Expectancy , Lymphocytes , Lymphohistiocytosis, Hemophagocytic , Peripheral Blood Stem Cell Transplantation , SiblingsABSTRACT
20?10~9/L.The proteinuria decreased or disappeared.The antinuclear antibody decreased or became negative.The level of complement was increased.The following complications were ob- served:septicemia in 2 patients,cytomegalovirus infection in 2 patients,renal toxicity in 1 patient,acute left heart failure in 3 patients and cardiac arrhythmia in 3 patients.There was no transplantation related mortality. Conclusion APBSCT may improve the disease activity and the immunological markers in SLE.It is a valid therapy for refractory SLE,but the long-term effects need to be observed.
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Objective To evaluate the immune reconstruction of patients with advanced gastric cancer treated by autologous peripheral blood stem cells following chemotherapy. Methods 54 patients with advanced stage of gastric cancer were accepted arterial chemotherapy under the guidance of DSA with the regimen of high dosage of EAP (VP16 100 mg/m 2, topmycine60 mg/m 2 and carplatine200 mg/m 2). Among them 20 patients underwent autologous peripheral blood stem cell transplantation after 48 hours of the chemothrapy. Results Effective rate of EAP arterial chemotherapy combined with autologous peripheral blood stem cell transplantation was up to 85.0% (17/20) in advanced gastric cancer, 29.3% (10/34) in control group ( P