程序性死亡受体1单抗联合CHOP方案治疗恶性淋巴瘤的临床疗效  

Clinical efficacy of programmed cell death 1 monoclonal antibody combined with CHOP regimen in the treatment of malignant lymphoma

作　　者：李言冰 蔡玲玉 左宏波 LI Yanbing;CAI Lingyu;ZUO Hongbo(Second Department of Oncology,Jiujiang No.1 People’s Hospital,Jiujiang 332000,Jiangxi,China)

机构地区：[1]九江市第一人民医院肿瘤二科,江西九江332000

出　　处：《癌症进展》2024年第8期885-888,共4页Oncology Progress

基　　金：江西省中医药管理局科技计划项目(2021B145)。

摘　　要：目的探讨程序性死亡受体1(PD-1)单抗联合环磷酰胺+表柔比星+长春新碱+泼尼松(CHOP)方案治疗恶性淋巴瘤(ML)的临床疗效。方法根据治疗方法的不同将82例ML患者分为CHOP组(n=39,单纯CHOP方案治疗)和PD-1联合治疗组(n=43,PD-1单抗联合CHOP方案治疗)。比较两组患者的临床疗效、免疫功能指标[CD4^(+)、免疫球蛋白G(IgG)和免疫球蛋白A(IgA)]、炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、肿瘤相关指标[血管内皮生长因子(VEGF)、诱导型一氧化氮合酶(iNOS)、乳酸脱氢酶(LDH)]及不良反应发生情况。结果PD-1联合治疗组患者的总有效率高于CHOP组,差异有统计学意义(P﹤0.05)。治疗后,两组患者CD4^(+)水平均高于本组治疗前,IgG、IgA水平均低于本组治疗前,PD-1联合治疗组患者CD4^(+)水平高于CHOP组,IgG和IgA水平均低于CHOP组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者IL-6、TNF-α、VEGF、iNOS、LDH水平均低于本组治疗前,PD-1联合治疗组患者IL-6、TNF-α、VEGF、iNOS、LDH水平均低于CHOP组,差异均有统计学意义(P﹤0.05)。PD-1联合治疗组患者的不良反应总发生率低于CHOP组,差异有统计学意义(P﹤0.05)。结论PD-1单抗联合CHOP方案治疗ML患者可提高临床疗效,改善免疫功能,减轻炎症反应,且可降低不良反应发生率。Objective To explore the clinical efficacy of programmed cell death 1(PD-1)monoclonal antibody combined with cyclophosphamide+epirubicin+vincristine+prednisone(CHOP)regimen in the treatment of malignant lymphoma(ML).Method A total of 82 ML patients were divided into CHOP group(n=39,CHOP regimen alone)and PD-1 combined treatment group(n=43,PD-1 monoclonal antibody combined with CHOP regimen)according to different treatment methods.The clinical efficacy,immune function indexes[CD4^(+),immunoglobulin G(IgG)and immunoglobulin A(IgA)],inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],tumor related indexes[vascular endothelial growth factor(VEGF),inducible nitric oxide synthase(iNOS),lactate dehydrogenase(LDH)]and the occurrence of adverse reactions were compared between the two groups.Result The overall response rate of PD-1 combined treatment group was higher than that of CHOP group,and the difference was statistically significant(P<0.05).After treatment,the CD4^(+)levels in the two groups were higher than those before treatment,the IgG and IgA levels were lower than those before treatment,and the CD4^(+)level in PD-1 combined treatment group was higher than that in CHOP group,the IgG and IgA levels were lower than those in CHOP group,and the differences were statistically significant(P<0.05).After treatment,the IL-6,TNF-α,VEGF,iNOS and LDH levels in the two groups were lower than those before treatment,and the IL-6,TNF-α,VEGF,iNOS and LDH levels in PD-1 combined treatment group were lower than those in CHOP group,and the differences were statistically significant(P<0.05).Conclusion PD-1 monoclonal antibody combined with CHOP regimen in the treatment of ML patients can improve clinical efficacy and immune function,reduce inflammatory response and the incidence of adverse reactions.

关 键 词：程序性死亡受体1 单抗 CHOP方案 恶性淋巴瘤 免疫功能 炎症因子 

分 类 号：R733.4[医药卫生—肿瘤]