利妥昔单抗联合二线方案治疗七例复发难治性霍奇金淋巴瘤患者疗效观察  

Rituximab combined with second line regimens for treatment of seven relapsed and refractory Hodgkin lymphoma patients

作　　者：刘慧敏[1] 李姮[1] 熊文婕 易树华 邹德慧 邱录贵 

机构地区：[1]中国医学科学院、北京协和医学院血液学研究所、血液病医院,实验血液学国家重点实验室,天津300020

出　　处：《中华血液学杂志》2015年第7期578-582,共5页Chinese Journal of Hematology

基　　金：国家科技支撑计划（2014BAl09812）;国家自然科学基金（81370632、81200395）;天津市科技支撑计划（重大科技专项）（12ZCDZSYl7600）

摘　　要：目的 探讨利妥昔单抗联合二线方案治疗复发难治性霍奇金淋巴瘤（HL）患者的疗效及安全性.方法 7例复发难治性HL患者中2例接受R-GDP（E）[利妥昔单抗、吉西他滨、顺铂、地塞米松、（依托泊苷）]方案治疗,2例接受R-IGVP（利妥昔单抗、异环磷酰胺、吉西他滨、长春瑞滨、泼尼松）方案治疗,3例接受R-BEACOPP（利妥昔单抗、博来霉素、依托泊苷、多柔比星、环磷酰胺、长春新碱、甲基苄肼、泼尼松）方案治疗.观察患者治疗过程中及其后的不良反应和疗效.结果 7例患者中男3例,女4例,发病时中位年龄21（12～36）岁;结节性淋巴细胞为主型HL（NLPHL）1例,经典型HL 6例（包括4例结节硬化型,1例淋巴细胞为主型和1例混合细胞型）.中位疗程数为4（1～4）个,中位随访时间为29（24～58）个月.7例患者中4例达完全缓解,2例达疾病稳定,1例死亡.2年总生存率为85.7％.不良反应均可耐受,以骨髓抑制为主.5例患者化疗后行外周血自体造血干细胞移植治疗.结论 利妥昔单抗联合二线方案治疗复发难治性HL患者安全、有效.Objective To investigate the efficacy and safety of Rituximab combined with second line regimen for treatment of relapsed and refractory Hodgkin lymphoma.Methods Seven patients with relapsed and refractory Hodgkin lymphoma were treated with Rituximab combined with second line regimen.Among them,two patients were treated with R-GDP （E） [rituximab,gemcitabine,cisplatin,dexamethasone （etoposide）] regimen,another two patients with R-IGVP （rituximab,ifosfamide,gemcitabine,vinorelbine,prednisone） regimen,and the left three patients with R-BEACOPP （rituximab,bleomycin,etoposide,doxombicin,cyclophosphamide,vincristine,procarbazine,prednisone） regimen.The efficacy and safety were evaluated during and after chemotherapy.Results There＆#39; re three male and four female patients,whose median age was 21 years （range 12-36 years） old.One patient was diagnosed as nodular lymphocyte-predominant Hodgkin lymphoma （NLPHL）,and the other six patients as classical HL （four nodular sclerosis HL,one lymphocyte-rich classical HL and one hmixed cellularity HL）.The median cycles of salvage therapy were 4（1-4）,and the median follow-up was 29 months （24-58 months）.Among these 7 patients,the complete remission was observed in 4 patients,stable disease in 2 patients,but one patient died during salvage therapy.The two-year survival rates were 85.7% and the major toxic effects were bone marrow suppression.Conclusion These results indicate that the Rituximab combined with second line regimen is an effective therapy for relapsed and refractory Hodgkin lymphoma.

关 键 词：复发 霍奇金病 外周血干细胞移植 利妥昔单抗 

分 类 号：R733.1[医药卫生—肿瘤]