口服氟达拉滨治疗慢性淋巴细胞白血病 小淋巴细胞淋巴瘤的疗效观察  

Effect of Oral Fludarabine Regimen on Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

作　　者：祝焱[1] 谢兆霞[1] 舒毅刚[1] 

机构地区：[1]中南大学湘雅医院血液科,长沙市410008

出　　处：《中国肿瘤临床》2010年第17期1006-1008,共3页Chinese Journal of Clinical Oncology

摘　　要：目的:评价口服氟达拉滨治疗慢性淋巴细胞白血病/小淋巴细胞性淋巴瘤(CLL/SLL)的疗效和不良反应。方法:15例CLL/SLL患者中CLL 10例,SLL 5例,中位年龄63岁。CLL患者按照Rai分期分为Ⅱ期5例,Ⅲ期2例,Ⅳ期3例。SLL患者临床分期为Ⅲ期4例,Ⅳ期1例。11例为初治患者,4例为复治患者。所有患者均口服氟达拉滨片40mg/(m^2·d),持续5天,每4周1疗程,至少连用4个疗程。12例患者完成4个疗程,3例患者4个疗程后分别又巩固1～2个疗程。结果:15例患者平均完成4.3个周期。完全缓解率66.7%(10/15),部分缓解率26.6%(4/15),1例(6.7%)无效,总有效率93.3%(14/15)。11例初治患者完全缓解9例,部分缓解1例,1例由于疾病进展死亡。4例复治患者1例完全缓解,3例部分缓解。不良反应主要为骨髓抑制和感染,5例(33.3%)出现中性粒细胞下降,1例Ⅰ级,3例Ⅱ级,1例Ⅲ级。感染3例(20%)。非血液系统毒性轻微,不良反应均可恢复。结论:口服氟达拉滨治疗CLL/SLL用药方便,疗效较理想,对既往治疗过的患者亦有较好疗效,不良反应较轻,对于CLL/SLL患者是值得推荐的治疗方案。To evaluate the therapeutic effect and adverse reaction of oral fludarabine in the treatment of chronic lymphocytic leukemia/small lymphocytic lymphoma （CLL/SLL）. Methods： Fifteen patients included 10 CLL patients and 5 SLL patients, and their media age was 63 years. According to Rai staging, 5 CLL patients were in stage Ⅱ ,2 in stage Ⅲ and 3 in stage Ⅳ. According to the clinical staging, there were 4 SLL patients in stage HI and 1 in stage Ill. Eleven patients were previously untreated while 5 were treated. All the patients received oral fludarabine 40mg/（m^2. d） for five consecutive days, repeated every 4 weeks for 4 cycles at least. Twelve patients went through 4 courses of treatment, and the other 3 patients continuously received one or two courses of consolidation therapy. Results： The average course of the 15 patients was 4.3. The rate of complete response （CR）, partial response （PR） and overall response （OR） were 66.7% （10/ 15）, 26.6% （4/15） and 93.3% （14/15） respectively, and one had no response to treatment. Nine of eleven previously untreated patients achieved CR while PR was obtained in one. And one died because of disease progression. Among four previously treated patients, one achieved CR and three achieved PR. The main adverse reactions were myelosuppression and infection. Grade Ⅰ - Ⅲ neutropenia were found in 5 （33.3%） patients in which 1 was with grade Ⅰ, 3 with grade Ⅱ and 1 with grade Ⅲ. Infection occurred in 3 （20%） patients. Nonhematologic toxicity was mild. All the adverse reactions were reversible. Conclusion： The oral fludarabine is an effective, safe regimen in patients with CLL/SLL. It is also effective to the previously treated patients. The adverse reactions are mild. The oral fludarabine is a recommendable therapy for the patients with CLL/SLL. lymphoma

关 键 词：氟达拉滨 慢性淋巴细胞白血病 小淋巴细胞淋巴瘤 

分 类 号：R733.71[医药卫生—肿瘤] R733.1[医药卫生—临床医学]