美罗华联合CTOP方案治疗B细胞非霍奇金淋巴瘤35例临床分析  

Clinical Analysis of the Effect of Rituximab in Combination with CTOP Chemotherapy on B Cell Non-Hodgkin's Malignant Lymphoma

作　　者：韩霞[1] 王华庆[1] 刘贤明[1] 邱立华[1] 张会来[1] 钱正子[1] 李维[1] 崔秀珍[1] 郝希山[1] 

机构地区：[1]天津医科大学附属肿瘤医院淋巴瘤科,天津市肿瘤防治重点实验室,中美淋巴血液肿瘤诊治中心,天津市300060

出　　处：《中国肿瘤临床》2010年第6期338-341,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:评价美罗华联合环磷酰胺、吡柔比星、长春新碱、泼尼松(R-CTOP方案)治疗B细胞非霍奇金淋巴瘤的疗效及不良反应,分析影响疗效的相关因素。方法:回顾性分析我院35例经病理证实为CD20+的B细胞非霍奇金淋巴瘤患者的临床资料,评估R-CTOP方案化疗的疗效及不良反应,分析性别、年龄、疾病分期、病理类型、LDH水平及IPI评分等影响疗效的相关因素。结果:35例患者中33例可评价疗效,其中完全缓解(CR)17例(51.5%),部分缓解(PR)11例(33_3%),有效率(CR+PR)84.8%。23例初治患者中,CR13例(56.5%),PR8例(34.8%),有效率(CR+PR)91_3%;10例复发难治患者中,CR4例(40%),PR3例(30%),有效率70%。疗效与性别、疾病分期、病理类型、LDH水平及IPI评分等因素无显著相关,年龄对疗效有一定影响(P=0.012)。35例患者中无治疗相关死亡,不良反应主要为骨髓抑制(Ⅲ～Ⅳ度白细胞下降32.1%),心脏毒性和脱发较轻,主要为Ⅰ～Ⅱ级反应。其它不良反应经对症处理后均可耐受。结论:R-CTOP方案治疗B细胞非霍奇金淋巴瘤有效率高且不良反应轻微,可作为治疗B细胞非霍奇金淋巴瘤特别是老年非霍奇金淋巴瘤患者的优先选择。Objective： To evaluate the efficacy and toxicity of rituximab combined with cyclophosphamide, pirarubicin, vincristine, and prednisone （R-CTOP regimen） for B cell non-Hodgkin＇s lymphoma and to analyze the influential factors for patient response.Methods： The clinical data of patients with CD20 antigen treated with R-CTOP regimen were reviewed and the influence of sex, age, clinical stage, pathological type, and level of LDH and IPI on patient response was analyzed.Results： A total of 33 patients were evaluated for objective response.The complete response （CR） rate was 51.5%, the par-ticel response （PR） rate was 33.3%, and the overall response rate was 84.8%.For the 23 de novo patients, the CR rate was 56.5 %, the PR rate was 34.8%, and the OR rate was 91.3%.While in the 10 recurrent patients, the CR rate was 40%, the PR rate was 30%, and the OR rate was 70%.Sex, clinical stage, pathological type, and the level of LDH and IPI were not significantly related to clinical response.While patient age was related to clinical response.None of the patients died of therapy-related side effects.The most frequent adverse event was myelosuppression （Ⅲ-Ⅳ decrease of leukocyte account-ed for 32.1%）.Cardiotoxicity and alopecia were mostly grade Ⅰ to grade Ⅱ.Other side effects can be tolerated after symp-tomatic treatment.Conclusion： R-CTOP regimen is a highly effective and well-toleraed therapy and should be the first choice in the treatment for B cell non-Hodgkin＇s lymphoma （NHL）, especially for senior patients.

关 键 词：利妥昔单抗 非霍奇金淋巴瘤 化疗 

分 类 号：R733.1[医药卫生—肿瘤]