GLIDE方案治疗初发进展期及复发难治性结外鼻型NK／T细胞淋巴瘤的疗效评估  

Efficacy of GLIDE chemotherapy for patients with newly diagnosed advanced-stage or relapsed/ refractory extranodal natural killer cell lymphoma

作　　者：季杰[1] 向兵 刘志刚[1] 贾永前[1] 朱焕玲[1] 牛挺[1] 潘崚[1] 常红[1] 黄杰[1] 吴俣[1] 李建军[1] 何川[1] 马洪兵[1] 唐韫[1] 董天[1] 刘霆[1] 

机构地区：[1]四川大学华西医院血液内科,成都610041

出　　处：《中华血液学杂志》2016年第9期751-755,共5页Chinese Journal of Hematology

摘　　要：目的研究GLIDE（吉西他滨、门冬酰胺酶、异环磷酰胺、地塞米松、依托泊苷）方案治疗初发进展期及复发难治性结外鼻型NK／T细胞淋巴瘤（ENKL）患者的有效性及安全性。方法纳入2010年3月至2016年3月收治的初发进展期及复发难治性ENKL患者42例，给予GLIDE方案化疗，中位疗程数为3（2-6）个，评估化疗结束后缓解率及早期（2个疗程后）缓解率，采用Kaplan—Meier方法统计无进展生存（PFS）及总生存（OS），同时采用Cox回归方法进行多因素分析，寻找影响患者PFS及OS的独立预后因素。结果31例（73．8％）患者达到完全缓解（CR），其中22例（52．4％）为早期CR，31例CR患者中14例接受序贯自体造血干细胞移植（ASCT）。1年PFS与OS率分别为65．6％和82．7％，4年PFS与OS率分别为48．2％和63．1％，中位OS时间未达到，中位PFS时间为30．5个月。多因素分析提示美国东部肿瘤协作组体能状态评分（ECOG评分）0～1分以及CR后序贯ASCT为减少复发、延长患者生存的有利因素。结论GLIDE方案能够有效治疗初发进展期及复发难治性ENKL，ECOG评分0-1分及CR后序贯ASCT治疗是患者获得较长PFS和OS时间的独立预后因素。Objective To evaluate the efficacy of gemcitabine, asparaginase , ifosfamide, dexamethasone and etoposide （GLIDE） combination for patients with newly diagnosed advanced-stage or relapsed/refractory extranodal natural killer cell lymphoma （ENKL）. Methods Fourty-two newly diagnosed advanced-stage or relapsed/refractory ENKL were enrolled from March 2010 to March 2016. Patients were treated with GLIDE for median 3 （2-6） cycles. Complete response （CR） rate, early CR （after 2 cycles） rate were evaluated after all treatment finished. Progression free survival （PFS） and overall survival （OS） were analyzed by Kaplan-Meier method and multivariate by Cox proportional hazards models. Results Thirty-one （73.8%） patients achieved CR with 22 （52.4%） in early CR after 2 cycles of GLIDE, and 14 underwent autologous stem cell transplantation （ASCT） after achieved CR. One year PFS and OS were 65.6% and 82.7%, 4 year PFS and OS were 48.2% and 63.1%, respectively, with a median PFS of 30,5 months. Multivariate analysis indicated ECOG score 0- 1 and ASCT after CR were independent prognostic factors for less relapse and longer survival. Conclusion GLIDE is an effective regiment for newly diagnosed advanced-stage and relapsed/refractory ENKL.

关 键 词：淋巴瘤 结外NK-T细胞 造血干细胞移植 抗肿瘤联合化疗方案 

分 类 号：R733.1[医药卫生—肿瘤]