PEG-rhG-CSF预防弥漫大B细胞淋巴瘤患者化疗后中性粒细胞缺乏的效果观察  

Efficacy of PEG-rhG-CSF in preventing chemotherapy-induced neutropenia for patients with diffuse large B-cell leukemia

作　　者：杨艳迪 陆滢 叶佩佩 YANG Yandi;LU Ying;YE Peipei(Medical School of Ningbo University,Ningbo 315000,China)

机构地区：[1]宁波大学医学院,315000 [2]宁波大学医学院附属鄞州人民医院血液内科

出　　处：《浙江医学》2020年第6期587-590,593,共5页Zhejiang Medical Journal

摘　　要：目的观察弥漫大B细胞淋巴瘤(DLBCL)患者应用聚乙二醇化重组人粒细胞刺激因子(PEG-rhG-CSF)预防化疗后中性粒细胞缺乏的效果及经济效益。方法回顾性分析80例DLBCL患者的临床资料,其中首次化疗后即使用PEG-rhG-CSF的患者33例(初级预防组),后续化疗后使用PEG-rhG-CSF的患者21例(次级预防组),未预防性使用PEG-rhG-CSF的患者26例(对照组)。比较3组患者4个化疗周期后中性粒细胞缺乏发生率、发热性中性粒细胞减少(FN)发生率、化疗及时率、完全缓解(CR)率以及住院时长和费用,同时观察PEG-rhG-CSF所致不良反应发生情况。结果(1)初级预防组、次级预防组、对照组化疗后中性粒细胞缺乏发生率分别为6.06%、19.05%、42.31%,初级预防组较对照组明显降低(P<0.05),余两两比较差异均无统计学意义(均P>0.05)。(2)初级预防组、次级预防组、对照组的FN发生率分别为6.06%、9.52%、30.77%,初级预防组较对照组降低(P<0.05),余两两比较差异均无统计学意义(均P>0.05)。(3)初级预防组的化疗及时率(93.94%)明显高于对照组(57.69%),差异有统计学意义(P<0.05),而次级预防组(80.95%)与对照组比较差异无统计学意义(P>0.05)。(4)3组化疗后CR率差异无统计学意义(均P>0.05)。(5)初级预防组患者住院时间、住院费用均少于对照组(P<0.05),次级预防组与对照组比较、初级预防组与次级预防组比较差异均无统计学意义(均P>0.05)。(6)与PEG-rhG-CSF相关的不良反应发生率不高,为5.56%。结论在DLBCL患者化疗中预防性使用PEG-rhG-CSF,能够有效降低化疗后中性粒细胞缺乏、FN发生率,确保化疗及时进行,且具有成本效益。Objective To investigate the efficacy and economic benefit of Pegylated recombinant human granulocyte colony-stimulating factor(PEG-rhG-CSF)in prevention of chemotherapy-induced neutropenia for patients with diffuse large B-cell leukemia(DLBCL).Methods Clinical data of 80 patients with DLBCL treated with chemotherapy from November 2016 to March 2019 were retrospectively analyzed,including 33 cases receiving PEG-rhG-CSF following the initial chemotherapy(primary prevention group),21 cases receiving PEG-rhG-CSF after the subsequent chemotherapy(secondary prevention group)and 26 case not receiving PEG-rhG-CSF(control group).The incidence of chemotherapy-induced neutropenia and febrile neutropenia,timely chemotherapy rate and complete response(CR)rate were recorded and compared.The average length of hospital stay and the average medical expenses of three groups were calculated and compared.And the adverse events induced by PEG-rhG-CSF was observed.Results The incidence of neutropenia in the primary prevention group was lower than that in control group(6.06%vs 42.31%,P<0.05);while there were no significant differences between the primary prevention and the secondary prevention group(6.06%vs 19.05%,P>0.05)and between the secondary prevention group and control group(19.05%vs 42.31%,P>0.05).The incidence of neutropenia with fever in the primary prevention group was significantly lower than that in the control group(6.06%vs 30.77%,P<0.05);while there was no significant difference between the primary prevention group and the secondary prevention group(6.06%vs 9.52%,P>0.05),and between the secondary prevention group and the control group(9.52%vs 30.77%,P>0.05).The timely chemotherapy rate in the primary and secondary prevention groups was both higher than that in the control group(93.94%vs 57.69%,P<0.05 and 80.95%vs 57.69%,P>0.05).There was no significant difference in CR rate among three groups(P>0.05).The length of hospital stay and the medical expenses in the primary prevention group were significantly lower than those i

关 键 词：聚乙二醇化重组人粒细胞刺激因子 弥漫大B细胞淋巴瘤 粒细胞缺乏 预防 经济效益 

分 类 号：R733.1[医药卫生—肿瘤]