R-BAP联合BTK抑制剂方案对初治套细胞淋巴瘤患者的疗效和安全性分析  

Efficacy and safety analyses of R-BAP in combination with BTK inhibitors in newly diagnosed patients with mantle cell lymphoma

作　　者：李文琪 陈子琪 孙金淼 常宇[1] 柳喜洋[1] 张明智[1] 张蕾[1] Wenqi Li;Ziqi Chen;Jinmiao Sun;Yu Chang;Xiyang Liu;Mingzhi Zhang;Lei Zhang(Department of Oncology,The First Affilitated HospitaI of Zhengzhou University,Lymphoma Diagnosis and Treatment Center,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院肿瘤科,河南省淋巴瘤诊疗中心,郑州市450052

出　　处：《中国肿瘤临床》2023年第24期1248-1253,共6页Chinese Journal of Clinical Oncology

基　　金：国家自然科学基金(青年基金)项目(编号:82000204);中国抗癌协会淋巴瘤研究基金会项目(编号:CORP-117);河南省科技项目(编号:232102311114)。

摘　　要：目的:探讨以利妥昔单抗、苯达莫司汀、阿糖胞苷和泼尼松联合布鲁顿氏酪氨酸激酶(Bruton's tyrosine kinase,BTK)抑制剂的方案治疗MCL患者的疗效和安全性,旨在改良套细胞淋巴瘤(mantle cell lymphoma,MCL)的治疗方案。方法:回顾性分析郑州大学第一附属医院2021年3月至2023年11月收治的26例初治MCL病例,采用利妥昔单抗、苯达莫司汀、阿糖胞苷和泼尼松联合BTK抑制剂治疗方案的疗效和不良反应。结果:26例初治MCL患者中位年龄为59(41~72)岁,其中男性22例、女性4例,中位随访时间为12(3~28)个月。在26例患者中,总缓解率(overall response rate,ORR)为92.3%,完全缓解率(complete response rate,CRR)为88.5%。中位无进展生存期(progression-free survival,PFS)和中位总生存期(overall survival,OS)均未达到,1年PFS率为81.25%,1年OS率为92.3%。MCL国际预后指数(MIPI)评分0~3分组的PFS优于MIPI评分4~11分组(P=0.020),无B症状组的PFS优于有B症状组(P=0.002),经典型组的PFS优于母细胞样/多形性变异组(P=0.009)。主要不良反应为淋巴细胞和血小板减少症,在随访期间未观察到与治疗相关的严重不良事件发生。结论:利妥昔单抗、苯达莫司汀、阿糖胞苷和泼尼松联合BTK抑制剂的方案在初治MCL患者中治疗是安全有效的。Objective:To improve the therapeutic regimen for mantle cell lymphoma,we investigated the efficacy and safety of adding a BTK inhibitor to a regimen including rituximab,bendamustine,cytarabine,and prednisone to treat patients with mantle cell lymphoma(MCL).Methods:Twenty-six patients newly diagnosed with MCL who were admitted to The First Affiliated Hospital of Zhengzhou University from March 2021 to November 2023 were treated with a regimen of rituximab,bendamustine,cytarabine and prednisone combined with a BTK inhibitor,and the efficacy and adverse effects of this regiment were retrospectively analyzed.Results:The median age of the 26 newly diagnosed MCL patients was 59(41-72)years.The cohort included 22 males and 4 females,and the median follow-up time was 12(3-28)months.The overall response rate(ORR)was 92.3% and the complete response rate(CRR)was 88.5%.Median progression-free survival(PFS)and median overall survival(OS)endpoints were not achieved,with a 1-year PFS rate of 81.25% and a 1-year OS rate of 92.3%.A better PFS was achieved in the low mantle cell lymphoma International Prognostic Index(MIPI)score(0-3 points)group than in the high MIPI score(4-11 points)group(P=0.020).PFS was better in the group without B symptoms than in the group with B symptoms(P=0.002).PFS was better in the classical group than in the pleomorphic-blastoid subtype group(P=0.009).The main adverse effects were lymphopenia and thrombocytopenia.No treatment-related serious adverse events were observed during the follow-up period.Conclusions:The regimen of rituximab,bendamustine,cytarabine,and prednisone in combination with BTK inhibitors is safe and effective for the treatment of newly diagnosed patients with MCL.

关 键 词：套细胞淋巴瘤 化疗 BTK抑制剂 疗效 安全性 

分 类 号：R733.1[医药卫生—肿瘤]