感染乙肝病毒的恶性淋巴瘤应用利妥昔单抗联合化疗的临床观察  

Rituximab combined with chemotherapy in treatment of non-Hodgkin′s lymphoma patients complicated with HBV infection

作　　者：叶煌阳[1] 张映红[1] 洪瑞芬[1] 李晓虹 陈莉林[1] 叶峰[1] 李佳艺[1] 蔡铭泉[1] 杨海燕[1] 

机构地区：[1]福建医科大学附属厦门第一医院肿瘤内科,福建厦门361003

出　　处：《中国肿瘤临床与康复》2010年第2期149-151,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨利妥昔单抗联合化疗治疗非霍奇金淋巴瘤合并乙型肝炎病毒携带者的安全治疗方法。方法8例感染HBV的NHL接受R-CHO方案化疗4～6周期及预防应用拉米夫定抗病毒治疗(A组),28例NHL接受R-CHOP方案化疗4～6周期(B组)。结果A组CR率(CR+CRu)为75.0%,B组CR率为85.7%(P=0.121)。Ⅰ～Ⅱ级肝功能损害发生率A组为12.5%,B组10.7%(P=0.715)。A组中未发生HBV再激活,B组中有1例HBsAg阴性而HBsAb阳性发生HBV激活(P=0.638)。结论感染HBV的NHL应用R-CHO联合方案治疗及在化疗前预防抗病毒治疗能明显降低HBV再激活。Objective To study the efficacy and safety of rituximab combined with chemotherapy in treatment of non-Hodgkin′s lymphoma（NHL） patients complicated with HBV infection.Methods Eight NHL with HBV infection patients were treated with R-CHO regimen for four or six cycles and preventive use of lamivudine antiviral treatment（group A）.Twenty eight NHL patients were treated with R-CHOP regimen for four or six cycles（group B）.Results The complete response rate was 75.0% in group A,and 85.7% in group B（χ2=2.409,P=0.121）.Ⅰ-Ⅱ-class live function impairment was 12.5% in group A,and 10.7% in group B（χ2=0.133,P=0.715）.In group A no hepatitis B reactivation occurred,while in group B hepatitis B reactivation occurred in one case of negative HBsAg and positive HBsAb（χ2=0.221,P=0.638）.Conclusion Non-Hodgkin′s lymphoma patients complicated with HBV infection treated with R-CHO regimen and preventive anti-virus therapy before chemotherapy can decrease hepatitis B reactivation.

关 键 词：乙肝病毒 非霍奇金淋巴瘤 利妥昔单抗 

分 类 号：R733.1[医药卫生—肿瘤] R730.58[医药卫生—临床医学]