氟达拉滨联合环磷酰胺治疗慢性淋巴细胞白血病41例的疗效评估  

Efficacy of fludarabine combined with cyclophosohamide for patients with chronic lymphocytic leukemia

作　　者：刘欣[1] 肖青[1] 刘芬[1] 吕敬龙[1] 

机构地区：[1]重庆医科大学附属第一医院血液科,重庆400016

出　　处：《重庆医科大学学报》2014年第4期548-552,共5页Journal of Chongqing Medical University

基　　金：重庆市卫生局重点项目课题(编号:2013-1-013)

摘　　要：目的:观察氟达拉滨联合环磷酰胺(fludarabine combined with cyclophosphamide,FC)方案治疗慢性淋巴细胞白血病(chronic lymphocytic leukemia,CLL)的近期临床疗效和不良反应。方法:回顾性分析2008年1月至2013年1月就诊于我院经FC方案治疗的41例CLL患者资料。结果:41例CLL患者的完全缓解(complete response,CR)率、部分缓解(partial response,PR)率及总缓解(overall response,OR)率分别为41.5%,36.6%及78.1%,而初治组CR率、PR率及OR率与复治组比较无显著性差异(58.8%、23.5%及82.4%vs.29.1%、45.8%及75%,P>0.05),而主要毒副作用是骨髓抑制和免疫功能抑制,而对于初治和复治组的血液毒性作用无显著性差异(P>0.05);完成4周期化疗的32例患者中,2年总生存(overall survival,OS)率及无病生存(disease free survival,DFS)率分别为59.1%和35%,其中,初治组2年DFS率优于复治组(53.6%vs.20.8%,P<0.05),而2组2年OS率无显著差异(77.1%vs.47.3%,P>0.05)。结论:FC方案对CLL近期疗效较好,耐受性好,有可能改善患者的预后提高DFS,值得推广和应用,但远期疗效有待进一步观察。Objective：To evaluate the efficacy of fludarabine combined with cyclophosphamide （FC） regimen for chronic lymphocytic leukemia （CLL）. Methods：Clinical data of 41 patients with CLL treated by FC regimen were retrospectively analyzed. Results：The rates of complete response（CR）, partial response （PR） and overall response （OR） were 41.5%, 36.6% and 78.1% respectively. There was no difference between initial and secondary treatment groups in CR,PR and OR rates （58.8%, 23.5%, 82.4% vs. 29.1%,45.8%, 75%,P〉0.05）. The main side effects were myelosuppression and immunologic function suppression and there was no difference in hematotoxicity between two groups（P〉0.05）. The overall survival （OS） and disease-free survival （DFS） rates of 32 patients who had finished 4 cycles of chemotherapy,were 59.1% and 35% respectively.The DFS rate of initial treatment group was better than that of secondary treatment group（53.6% vs. 20.8%,P〈0.05） ,but there was no difference in OS rate between two groups（77.1% vs. 47.3% ,P 〉0.05）. Conclusions：FC combined chemotherapty regimen can improve the prognosis and disease-free survival of patients with CLL. It is the currently preferred scheme for patients with CLL due to its good efficacy and tolerance, but more attention should be paid to the long-term effect.

关 键 词：氟达拉滨 环磷酰胺 慢性淋巴细胞白血病 

分 类 号：R733.72[医药卫生—肿瘤] R730.53[医药卫生—临床医学]