利妥昔单抗联合CHOP与单用CHOP方案治疗初治弥漫大B细胞淋巴瘤疗效及安全性对比  

Comparison of the efficacy and safety of rituximab plus CHOP and CHOP alone regimens in patients with newly diagnosed diffuse large B-cell lymphoma

作　　者：陈艳欣[1] 郑晓云[1] 刘庭波[1] 郑静[1] 郑志宏[1] 胡建达[1] 

机构地区：[1]福建医科大学附属协和医院血液科,福建省血液病研究所,国家及福建省临床重点专科,福州350001

出　　处：《临床血液学杂志》2015年第5期760-763,共4页Journal of Clinical Hematology

基　　金：卫生行业科研专项(No:201202017;重大血液病诊断规范化和治疗策略优化的研究)

摘　　要：目的：探讨使用利妥昔单抗联合CHOP或单用CHOP方案化疗治疗初治弥漫大B细胞淋巴瘤（DLBCL）的疗效及安全性。方法：回顾性分析144例初治DLBCL患者的临床资料，分为利妥昔单抗联合化疗（R—CHOP组，99例）和单用化疗（CHOP组，45例），至少化疗4个疗程，中位随访25（2～74）个月，比较2组疗效及不良反应。结果：99例R-CHOP组中，66例（66．7％）达完全缓解（CR），23例（23．2％）达部分缓解（PR），1例（1．0％）疾病稳定（SD），9例（9．1％）疾病进展（PD），总有效率（ORR）为89．9％，3年总生存（OS）、无进展生存（PFS）率分别为82．1％和69．6％。45例CHOP组中，22例（48．9％）达CR，18例（40．0％）达PR，5例（11．1％）PD，ORR为88．9％，3年OS、PFS率分别为60．7％和57．9％。R—CHOP组较cHOP组cR率显著增高（P=0．043），OS和PFS显著延长（P值分别为0．041、0．046）。年龄≤60岁的R—cHOP组较CHOP组CR率及OS、PFS率显著提高（P值分别为0．014、0．004、0．007）。非生发中心型的R—CHOP组CR率较CHOP组显著增高（P=0．012）。生发中心型的R-CHOP组较CHOP组OS、PFS显著延长（P值分别为0．025、0．004）。不良反应主要为骨髓抑制和胃肠道反应，2组不良反应相似。结论：利妥昔单抗联合CHOP化疗较单用CHOP化疗可以明显提高初治DLBCL的缓解率并延长生存期，且安全性好。Objective：To evaluate the efficacy and safety of rituximab plus CHOP and CHOP alone regimens in patients with newly diagnosed diffuse large B-cell lymphoma （DLBCL）. Method：A total of 144 patients with newly diagnosed DLBCL were retrospectively studied. Ninety-nine cases were treated with rituximab plus chemotherapy （R CHOP group） and 45 cases with chemotherapy alone （CHOP group） regimen for at least four cycles,with a median follow up for 25 （2 to 74） months. The efficacy and adverse effects between two groups were compared. Result：Among 99 patients with rituximab plus CHOP chemotherapy, 66 （66. 7%） achieved complete remission （CR） ,23 （23.2%） achieved partial remission （PR） ,1 （1.0%） had stable disease （SD） ,9 （9.1%） had progressive disease （PD）, with 89. 9% overall response rates （ORR）. Overall survival （OS） and progression free survival （PFS） at 3 years were 82. 1% and 69. 6%. Among 45 patients in CHOP group,22 （48. 9%） achieved CR,18 （40.0%） achieved PR,5 （11.1%） had PD;ORR were 88.9%,OS and PFS at 3 years were 60.7% and 57.9%. Patients in R-CHOP group showed superior CR rates, OS and PFS （P= 0. 043,0. 041,0. 046, respectively）. Patients at 60 years of age or younger treated with R-CHOP regimen displayed a significant better CR rates,OS and PFS （P=0. 014,0. 004,0. 007, respectively） than CHOP therapy. After R-CHOP treatment, CR rates were improved for patients with non GCB type （P=0. 012） and OS,PFS were improved for patients with GCB type （P= 0. 025,0. 004,respectively）. Common adverse events were myelosuppression and gastrointestinal reaction. Adverse effects were similar between two groups.Conclusion： The treatment of rituximab plus CHOP lead to higher CR rates and longer survival than CHOP alone regimen with well safety in patients with newly diagnosed DLBCL.

关 键 词：淋巴瘤 大B细胞 弥漫性 利妥昔单抗 化疗 疗效 

分 类 号：R733.4[医药卫生—肿瘤]