利妥昔单抗联合化疗治疗小B细胞淋巴瘤的效果及安全性  

Efficacy and safety of rituximab combined with chemotherapy for small B-cell lymphoma

作　　者：姬冉 李运斌[1] 田利伟 赵姗姗 陈琛[1] JiRan;Li Yunbin;Tian Liwei;Zhao Shanshan;Chen Chen(Department of Hematology,Zaozhuang Municipal Hospital,Zaozhuang 277100,China)

机构地区：[1]枣庄市立医院血液内科,枣庄277100

出　　处：《白血病．淋巴瘤》2024年第6期339-342,共4页Journal of Leukemia & Lymphoma

摘　　要：目的探讨利妥昔单抗联合化疗治疗小B细胞淋巴瘤的临床效果及安全性。方法回顾性系列研究。回顾性分析枣庄市立医院2017年1月至2022年8月有完整随访资料的接受利妥昔单抗联合化疗治疗的44例小B细胞淋巴瘤患者资料, 分析患者的临床病理特征及预后情况。结果 44例小B细胞淋巴瘤患者中, 男性28例, 女性16例;年龄(62±13)岁;慢性淋巴细胞白血病27例, 滤泡淋巴瘤7例, 淋巴浆细胞淋巴瘤/华氏巨球蛋白血症2例, 脾边缘区淋巴瘤3例, 淋巴结边缘区淋巴瘤1例, 毛细胞白血病1例, B细胞慢性淋巴增殖性疾病不能分型3例。随访时间[M(Q_(1), Q_(3))]35.5个月(18.5个月, 52.0个月), 完全缓解(CR)率61.36%(27/44), 部分缓解率29.55%(13/44), 客观缓解率90.91%(40/44)。不同β2-微球蛋白、乳酸脱氢酶、ZAP-70表达水平患者的CR率比较, 差异均有统计学意义(均P<0.05), 而不同年龄、性别、骨髓浸润情况患者CR率比较, 差异均无统计学意义(均P>0.05)。截至末次随访, 中位总生存(OS)时间未达到, 中位无进展生存(PFS)时间为65个月。血液学不良反应发生率为27.27%(12/44), 耐受性良好;未观察到严重的非血液学不良反应。结论利妥昔单抗联合化疗可提高小B细胞淋巴瘤患者疗效, 延长PFS和OS时间, 不良反应可耐受。Objective:To investigate the clinical efficacy and safety of rituximab combined with chemotherapy in the treatment of small B-cell lymphoma.Methods:A retrospective series study was conducted.The clinical data of 44 small B-cell lymphoma patients with complete follow-up data who received rituximab combined with chemotherapy in Zaozhuang Municipal Hospital from January 2017 to August 2022 were retrospectively analyzed.The clinicopathological characteristics and prognosis of patients were also analyzed.Results:All the 44 patients with small B-cell lymphoma included 28 males and 16 females;the age was(62±13)years.Among the 44 patients,there were 27 cases of chronic lymphocytic leukemia,7 cases of follicular lymphoma,2 cases of lymphoplasmacytic lymphoma/Waldenstr?m macroglobulinemia,3 cases of splenic marginal zone lymphoma,1 case of lymph node marginal zone lymphoma and 1 case of hair-cell leukemia,3 cases of unclassified B-cell chronic lymphocyte proliferative disease.Follow-up time[M(Q_(1),Q_(3))]was 35.5 months(18.5 months,52.0 months).The complete remission(CR)rate,partial remission rate and the objective remission rate was 61.36%(27/44),29.55%(13/44)and 90.91%(40/44),respectively.There were statistically significant differences in CR rates in patients with different expression levels ofβ2-microglobulin,lactate dehydrogenase and ZAP-70(all P<0.05),while the differences in CR rates among patients with different age,gender and bone marrow infiltration were not statistically significant(all P>0.05).Until the last follow-up,the median overall survival(OS)time was not reached,the median progression-free survival(PFS)time was 65 months.The incidence of hematological adverse reactions was 27.27%(12/44),which was well tolerated.No serious non-hematological adverse reactions were observed.Conclusions:Rituximab combined with chemotherapy could improve the therapeutic effect,prolong PFS and OS time of patients with small B-cell lymphoma.The adverse reactions can be tolerated.

关 键 词：淋巴瘤 B细胞 利妥昔单抗 免疫疗法 治疗结果 

分 类 号：R733.1[医药卫生—肿瘤]