利妥昔单抗对儿童高分期成熟B细胞非霍奇金淋巴瘤的疗效研究  

Efficacy of Rituximab on High-stage Mature B-cell Non-Hodgkin Lymphoma in Children

作　　者：周令 李战华 李运玲 ZHOU Ling;LI Zhanhua;LI Yunling(Zhumadian Central Hospital,Zhumadian,463000)

机构地区：[1]河南省驻马店市中心医院,463000

出　　处：《实用癌症杂志》2022年第1期146-149,共4页The Practical Journal of Cancer

基　　金：2019年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20190047)。

摘　　要：目的探讨儿童高分期、成熟B细胞非霍奇金淋巴瘤标准化疗联合利妥昔单抗治疗的的有效性和安全性。方法收治儿童非霍奇金淋巴瘤62例,为St.Jude分期Ⅲ~Ⅳ的患者,35例采用法国儿童肿瘤协会系列研究(lymphomes malins B,LMB)89方案,27例采用LMB89联合利妥昔单抗治疗方案,分析两组患儿的临床资料特征、治疗效果,Kaplan-Meier方法进行生存分析。结果原发部位、病理诊断、临床分期、乳酸脱氢酶≥2ULN者和骨髓和(或)中枢神经受累等参数两组相比均无统计学差异(P>0.05)。治疗后,LMB89组中有5例继发感染,LMB89+利妥昔单抗组为8例,差异无统计学意义(P>0.05)。两组发生肿瘤溶解综合征的患儿例数分别为4例和2例,差异无统计学意义(P>0.05)。LMB89组在化疗过程中出现肝功能受损1例,肠穿孔1例。LMB89+利妥昔单抗组出现肝功能受损1例,两组化疗出现并发症总数相比无统计学意义(P>0.05)。LMB89组5年无事件生存率为68.8%,5年总生存率为62.9%,LMB89+利妥昔单抗组5年的无事件生存率为92.6%,5年总生存率为92.6%,两组比较差异均有统计学意义(P=0.041,P=0.022)。结论标准LMB化疗联合利妥昔单抗能够显著改善高级别成熟B细胞非霍奇金淋巴瘤患儿的无事件生存期和总生存期,且未观察到不良反应事件增加,但是利妥昔单抗联合化疗药物的治疗方法的有效性及安全性仍需大样本的多中心、随机、对照研究进一步证实。Objective To explore the effectiveness and safety of standard chemotherapy combined rituximab in children with high-stage and mature B-cell non-Hodgkin's lymphoma.Methods 62 children with non-Hodgkin's lymphoma were collected.They were stageⅢ~ⅣSt.Jude.35 cases were based on the French Children Oncology Association series(lymphomes malins B,LMB)89 program,27 cases were treated with LMB89 combined with rituximab,and the clinical data characteristics,treatment effects,and Kaplan-Meier method of the 2 groups were analyzed for survival analysis.Results The primary site,pathological diagnosis,clinical stage,lactate dehydrogenase≥2ULN and bone marrow and(or)central nervous system involvement were compared between the 2 groups There was no statistical difference(P>0.05).After treatment of 62 children,there were 5 cases of secondary infection in the LMB89 group and 8 cases in the LMB89+rituximab group.The difference was not statistically significant(P>0.05).The numbers of children with tumor lysis syndrome in the 2 groups were 4 and 2 respectively,and the difference was not statistically significant(P>0.05).In the LMB89 group,there was 1 case of liver function impairment and 1 case of intestinal perforation during chemotherapy.There was 1 case of liver function impairment in the LMB89+rituximab group,and the total number of chemotherapy complications in the 2 groups was not statistically significant(P>0.05).The 5-year event-free survival rate in the LMB89 group was 68.8%,and the 5-year overall survival rate was 62.9%.The 5-year event-free survival rate in the LMB89+rituximab group was 92.6%and the 5-year overall survival rate was 92.6%.Compared the 5-year event-free survival rate and 5-year overall survival rate between the 2 groups,the difference was statistically significant(P=0.041,P=0.022).Conclusion Standard LMB chemotherapy combined with rituximab can significantly improve the event-free survival and overall survival of children with high-grade mature B-cell non-Hodgkin's lymphoma,and no increase in adverse ev

关 键 词：利妥昔单抗 化疗 非霍奇金淋巴瘤 B细胞 儿童 

分 类 号：R738.7[医药卫生—肿瘤]