硼替佐米联合阿霉素及地塞米松治疗复发难治性套细胞淋巴瘤15例  

Bortezomib Combined with Doxorubicin and Dexamethasone for Patients with Refractory Senile Mantle Cell Lymphoma

作　　者：张永清[1] 石炳毅[1] 陈协群[2] 夏永寿[2] 叶丽萍[1] 刘丽辉[1] 施兵[1] 

机构地区：[1]解放军总参谋部总医院血液科,北京市100091 [2]第四军医大学西京医院血液科

出　　处：《中国肿瘤临床》2011年第18期1092-1094,共3页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨硼替佐米联合阿霉素、地塞米松组成的PAD(bortezomib、doxorubicin and dexamethasone)方案治疗复发、难治性套细胞淋巴瘤(mantle cell lymphoma,MCL)的疗效及安全性。方法:用PAD方案治疗15例复发、难治性MCL,分析其疗效及影响因素,同时观察不良反应。PAD方案治疗4～6个疗程:硼替佐米(1.3 mg/m^2,d1、4、8、11,快速静脉注射)、阿霉素(10mg/d,d4～6,静脉注射)和地塞米松(40mg/d,d4～6,口服,每21天为1个疗程)。结果:80%(12/15)患者达PR及PR以上疗效,其中CR26.7%(4/15,均经PET-CT证实),PR 53.3%(8/15)。无病进展时间(PFS)13.5(3.5～25.1)个月,中位生存时间(OS)35.6(6.3～42.8)个月。PAD方案主要不良反应表现为:Ⅲ～Ⅳ级血小板减少(33.3%),Ⅱ级乏力(26.7%),Ⅱ级周围神经炎(13.3%),带状疱疹病毒感染(20.0%)。结论:PAD方案可有效提高难治性MCL患者疗效,不良反应多轻微可控。Objective： To explore the efficacy and safety of the bortezomib combined with doxorublcln and aexametnasone （ PAD ） regimen in the treatment of refractory/advanced senile mantle cell lymphoma. Methods： The activity and safety of the PAD regimen were investigated in 5 senile patients with refractory/advanced mantle cell lymphoma. Four to six 21-day cycles of PAD regimen consisted ofbortezomib （ 1.3 mg/m2, days 1, 4, 8, and 11 ）, doxorubicin （ 10 mg, day 1 ）, dexamethasone （ 40 mg, days 1-4 ）. Results： Four/five patients achieved ≥ PR response, with 2 patients achieving a complete response （also negative for disease activity by positron emission tomography scanning ）. Median progression free and overall survival was 12.3 （ 3.5-23.8 ） and 31.8 （ 6.3-41.7 ） months, respectively. The toxic effects of the PAD regimen included grade II thrombocytopenia （2/5）, grade IV thrombocytopenia （1/5）, grade Ⅱ neutropenia （ 2/5 ）, grade Ⅱ fatigue （ 1/5 ）, grade II peripheral neuropathy （ 1/5 ）, herpes zoster （ 1/5 ）. Conclusions： Bortezomib combined with doxorubicin and dexamethasone might be a promising therapy, with efficacy and manageable adverse events in senile patients with refractory/advanced mantle cell lymphoma.

关 键 词：硼替佐米 套细胞淋巴瘤 复发 

分 类 号：R733.1[医药卫生—肿瘤]