利妥昔单抗联合化疗治疗弥漫性大B细胞淋巴瘤的临床观察  

Clinical Analysis of Rituximab Combined with Chemotherapy in the Treatment of Diffuse Large B-cell Lymphoma

作　　者：席昱[1,2] 胡晓抒[1] 吴剑秋[2] 

机构地区：[1]南京医科大学公共卫生学院,南京210029 [2]江苏省肿瘤医院,南京210009

出　　处：《药学与临床研究》2013年第5期566-569,共4页Pharmaceutical and Clinical Research

摘　　要：目的：评价利妥昔单抗联合化疗治疗弥漫性大B细胞淋巴瘤（DLBCL）的疗效及安全性.方法：116例DLBCL患者接受利妥昔单抗联合化疗方案,中位治疗4.73个疗程.初治DLBCL患者112例,其中R-CHOP 87例,R-CHOP样29例；26例在化疗中进展.采用Cheson标准及WHO标准评估疗效及不良反应.结果：116例患者全部进行疗效评价,总体客观有效率为75％ （87/116）,CR ＋CRu为34例（29.31％）,PR为53例（45.69％）,SD为12例（10.34％）,PD为17例（14.66％）.其中1例患者在挽救方案获得缓解后,接受自体干细胞支持下的超大剂量化疗.主要不良反应为骨髓抑制,消化道反应,轻度肝损伤,首次输注反应2例.中位随访52.3（3.2～86.5）月,6例死于肿瘤进展,2例死于骨髓抑制后合并重度感染.中位生存期60.54月（3.2～86.5）,其中1、3、5年总生存率分别为81％、63％、52％,无病生存期1、3、5年总生存率分别为76％、52％、47％.在影响疗效相关因素分析中,IPI评分Ann、Arbor分期和LDH水平为影响患者化疗效果的相关因素（P＜0.05）.结论：利妥昔单抗联合治疗DLBCL的疗效确切,不良反应可以耐受,效果与文献报道一致.Objective：To investigate the efficacy and toxicity of rituximab combined with chemotherapy in the treatment of diffuse large B-cell lymphoma （DLBCL）.Methods：One hundred and sixteen patients with DLBCL were treated by rituximab combined with chemotherapy,with median duration of 4.73 courses.One hundred and twelve patients with DLBCL received rituximab combined with chemotherapy as initial treatment,eighty-seven patients were with R-CHOP and the rest were with R-CHOP-Like.Curative effects and adverse reactions were evaluated by Cheson and the WHO standard.Result：The objective response （OR） rate was 75％ （87/116） in these patients with a complete response （CR） rate of 29.31％,partial response （PR） rate of 45.68％,stable disease （SD） rate of 10.34％ and progressive disease （PD） rate of 14.66％.The major adverse effects included bone marrow suppression and moderate liver damage.Two patients had infusion reactions at the first time,one patient had interstitial pneumonia.The median followup was 61.75 （3.2～86.5） months.Twenty-six patients died of tumor progression and two died from grade 4 myelosuppression accompanied by severe systemic infection.The 1,3 and 5 year overall survival rate was 81％,63％ and 52％,respectively.The 1,3 and 5 year progression-free survival rate was 76％,52％ and 47％,respectively.It was found that serum LDH level,PS score and Ann Arbor staging were factors influencing the therapeutic efficacy of chemotherapy for the patients （P＜0.05）.Conclusion：Rituximab combined with chemotherapy in the treatment of diffuse large B-cell lymphoma is effective and well tolerable,but a further clinical trial is warranted.

关 键 词：弥漫性大B细胞淋巴瘤 利妥昔单抗 化疗 不良反应 

分 类 号：R969.4[医药卫生—药理学]