利妥昔单抗联合CHOP方案治疗弥漫大B细胞淋巴瘤的临床效果及影响因素  

Clinical effect and influencing factors of Rituximab combined with CHOP regimen in the treatment of diffuse large B-cell lymphoma

作　　者：陆琴 LU Qin(Department of Hematology,Haimen District People's Hospital,Jiangsu Province,Nantong226100,China)

机构地区：[1]江苏省南通市海门区人民医院血液科,江苏南通226100

出　　处：《中国当代医药》2024年第2期80-83,共4页China Modern Medicine

摘　　要：目的探讨利妥昔单抗联合CHOP方案治疗弥漫大B细胞淋巴瘤(DLBCL)的临床效果及影响因素。方法回顾性分析2015年1月至2020年3月南通市海门区人民医院血液科收治的62例DLBCL患者临床资料,患者均采用妥昔单抗联合CHOP方案治疗,根据治疗后的临床疗效分为缓解组与未缓解组。比较两组患者的各项临床资料,采用多因素logistic回归分析疗效的影响因素,比较两组患者的3年总生存率。结果治疗后缓解组108例,未缓解组16例。两组患者的初次化疗情况、改良AnnArbor分期、有无骨髓侵犯、有无淋巴瘤B症状、红细胞沉降率(ESR)、血清乳酸脱氢酶(LDH)比较,差异有统计学意义(P<0.05)。多因素logistic回归分析结果提示,改良AnnArbor分期(β=1.667,OR=1.791,95%CI:1.376~3.151)、ESR水平(β=0.775,OR=1.259,95%CI:1.172~2.903)、有淋巴瘤B症状(β=0.389,OR=0.720,95%CI:0.307~1.094)是影响利妥昔单抗联合CHOP方案治疗DLBCL患者疗效的独立危险因素。缓解组的3年总生存率为64.58%,高于未缓解组的14.29%,差异有统计学意义(P<0.05)。结论在临床上治疗DLBCL时,对于AnnArbor分期Ⅲ~Ⅳ期、ESR偏高以及存在淋巴瘤B症状的患者,应该在利妥昔单抗联合CHOP方案上推荐更加积极的治疗方案,以进一步提高临床疗效。Objective To investigate the clinical effect and influencing factors of rituximab combined with CHOP in the treatment of diffuse large B-cell lymphoma(DLBCL).Methods Clinical data of 62 DLBCL patients admitted to the Department of Hematology,Haimen District People's Hospital from January 2015 to March 2020 were retrospectively analyzed.All patients were treated with Tuximab combined with CHOP,and were divided into remission group and non-remission group according to the clinical efficacy after treatment.The clinical data of the two groups were compared,the influencing factors of efficacy were analyzed by multivariate logistic regression,and the 3-year overall survival rate was compared between the two groups.Results There were 108 cases in remission group and 16 cases in non-remission group after treatment.There were statistically significant differences in initial chemotherapy,modified AnnArbor stage,presence or absence of bone marrow invasion,presence or absence of lymphoma B symptoms,erythrocyte sedimentation rate(ESR)and serum lactate dehydrogenase(LDH)between two groups(P<0.05).Multivariate logistic regression analysis showed that the improved AnnArbor stage(β=1.667,OR=1.791,95%CI:1.376-3.151),ESR level(β=0.775,OR=1.259,95%CI:1.172-2.903)and lymphoma B symptoms(β=0.389,OR=0.720,95%CI:0.307-1.094)were independent risk factors for the efficacy of rituximab combined with CHOP in DLBCL patients.The 3-year overall survival rate in the remission group was 64.58%,higher than 14.29%in the non-remission group,and the difference was statistically significant(P<0.05).Conclusions In the clinical treatment of DLBCL,for patients with AnnArbor stageⅢ~Ⅳ,high ESR and lymphoma B symptoms,more active treatment scheme should be recommended on the combination of Rituximab and CHOP to further improve the clinical efficacy.

关 键 词：弥漫大B细胞淋巴瘤 利妥昔单抗 CHOP方案 影响因素 总生存率 

分 类 号：R733.4[医药卫生—肿瘤]