减低剂量利妥昔单抗联合CHOP方案治疗老年弥漫性大B细胞淋巴瘤的疗效观察  

Clinical outcome of reduced-dose rituximab combined with CHOP chemotherapy in treatment of diffused large B cell lymphoma for elderly patients

作　　者：祝彪[1] 向洪[1] 甘茂周[1] 李惠[1] 黄小兵[1] 黄娟[1] 王春森[1] 

机构地区：[1]四川省医学科学院·四川省人民医院血液科,成都610072

出　　处：《国际输血及血液学杂志》2016年第2期93-99,共7页International Journal of Blood Transfusion and Hematology

基　　金：国家自然科学基金（81500173）

摘　　要：目的观察减低剂量利妥昔单抗＋环磷酰胺＋多柔比星＋长春新碱＋泼尼松（融cHOP）方案与减低剂量环磷酰胺＋多柔比星＋长春新碱＋泼尼松（CHOP）方案治疗老年弥漫性大B细胞淋巴瘤（DLBCL）的临床疗效及不良反应。方法选取2007年1月至2013年6月，四川省医学科学院·四川省人民医院血液科收治的老年DLBCL患者66例为研究对象。全部患者均经组织病理学及免疫组织化学检测，且均符合《世界卫生组织造血及淋巴组织肿瘤分类（2008年版）》中关于DLBCL的诊断标准，明确诊断为DLBCL。本研究纳入标准：①符合DLBCL的诊断标准；②年龄〉60岁；③Ann Arbor临床分期为Ⅱ～Ⅳ期。排除标准：①患者入院前已接受其他药物或手术治疗；②患者在本次人院前已合并严重的肝、肾疾病，以及恶性肿瘤等严重系统性疾病；③患者对本次治疗应用的药物有变态反应史。采用简单随机法将66例老年DLBCL患者分为2组，分别为减低剂量R—CHOP方案化疗组（n=27）与减低剂量CHOP方案化疗组（n=39）。66例初治老年DLBCL患者66例应用减低剂量CHOP或R—CHOP方案进行化疗，每例患者治疗至少3个周期评估疗效，能够耐受减低剂量R—CHOP或CHOP方案的老年DLBCL患者，行化疗4～6个周期，即1个疗程。对老年DLBCL患者进行近期治疗反应的评估，并随访观察总生存（OS）率，无进展生存（PFS）率及无事件生存（EFS）率。并观察老年DLBCL患者接受减低剂量CHOP或R-CHOP方案进行化疗后的不良反应。本研究遵循的程序符合四川省医学科学院·四川省人民医院人体试验委员会所制定的伦理学标准，得到该委员会批准，征得受试对象的知情同意，并与之签署临床研究知情同意书。两组患者年龄、性别构成比等一般临床资料比较，差异均无统计学意义（P〉0.05）。结果①减低剂量R—CHOP方案化疗组27例老年DObjective To observe the clinical outcome and adverse reaction of reduced-dose rituximab- cyclophosphamide, doxorubicin, vincristine and prednisone （R-CHOP） chemotherapy and reduced-dose cyclophosphamide, doxorubicin, vincristine and prednisone （CHOP） chemotherapy for the treatment of elderly patients with diffuse large B cell lymphoma （DLBCL）. Method From January 2007 to June 2013, a total of 66 elderly patients with DLBCL at Hematology Department of Sichuan Provincial People＇s Hospital, Sichuan Academy of Medical Sciences were chosen as subjects of this study. All patients were received histopathological and immunohistochemical detection, and were consistent with the diagnosis of DLBCL in World Health Organization classification of tumors of hernatopoietic and lymphoid tissues （2008 edition）. Inclusion criteria of this study： ①consistent with DLBCL diagnose standard; ② aged over 60 years of age; ③ Ann Arbor clinical staging is II -IV period. Exclusion criteria： ① patients received other medications or surgery before admitted to the hospital; ② serious liver and kidney disease, as well as serious systemic diseases such as malignant tumor; ③ drug allergy. Sixty-six cases of elderly patients with DLBCL were divided into two groups by simple random method, as reduced-dose R-CHOP chemotherapy group （n=27） and reduced-dose CHOP chemotherapy group（n= 39）. Sixty-six cases of elderly patients with DLBCL were treated by reduced-dose R-CHOP or CHOP chemotherapy for at least three courses. For these can tolerate reduced-dose R-CHOP or CHOP chemotherapy, 4-6 courses which is a chemotherapy cycle were applied. Evaluation of treatment response was performed, and overall survival （OS） rate, progression-free survival （PFS） rate and event-free survival （EFS） rate were followed. And adverse reaction of elderly patients with DLBCL who received reduced-dose R-CHOP or CHOP chemotherapy were analyzed. The study protocol was approved by the Ethical Review Board of Investigation i

关 键 词：R-CHOP方案 CHOP方案 淋巴瘤 大&细胞 弥漫性 老年人 

分 类 号：R733.1[医药卫生—肿瘤]