单疗程CCR方案治疗毛细胞白血病4例临床效果及安全性  

Clinical efficacy and safety of single course CCR regimen in treatment of hairy cell leukemia:report of 4 cases

作　　者：高玲 缪祎 施文瑜[2] 李建勇[1] 朱华渊[1] Gao Ling;Miao Yi;Shi Wenyu;Li jianyong;Zhu Huayuan(Department of Hematology,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing 210029,China;Department of Oncology,Affiliated Hospital of Nantong University,Nantong226000,China)

机构地区：[1]南京医科大学第一附属医院、江苏省人民医院血液科,南京210029 [2]南通大学附属医院肿瘤科,南通226000

出　　处：《白血病．淋巴瘤》2024年第7期416-420,共5页Journal of Leukemia & Lymphoma

基　　金：国家自然科学基金(82170166);宿迁市科技计划(SY202218)。

摘　　要：目的探讨单疗程CCR(环磷酰胺+克拉屈滨+利妥昔单抗)方案治疗毛细胞白血病(HCL)的临床效果及安全性。方法回顾性病例系列研究。收集2015年10月至2023年3月南京医科大学第一附属医院收治的4例接受单疗程CCR方案治疗的初诊HCL患者临床资料,总结CCR方案的近期疗效和安全性,采用Kaplan-Meier法评估患者生存情况。结果4例患者均为初治经典型HCL,男性3例,女性1例,中位年龄46岁(范围:41~66岁)。4例患者中位随访34.5个月(范围:4~92个月)。治疗结束后4个月,完全缓解(CR)3例,部分缓解(PR)1例;3例CR患者均不伴微小残留病。Kaplan-Meier法预估示,4例患者5年均无进展生存和总生存。治疗过程中无严重药物相关不良事件发生,无利妥昔单抗相关的输注反应发生;2例发生1级疲乏,1例发生2级肺炎;1例发生4级粒细胞减少,3例发生4级血小板减少,无出血事件发生;所有不良反应可控。结论单疗程CCR方案治疗HCL效果良好,有较好安全性,可作为临床治疗HCL的新尝试。Objective:To explore the clinical efficacy and safety of CCR(cyclophosphamide+clarithrobin+rituximab)regimen in the treatment of hairy cell leukemia(HCL).Methods:A retrospective case series study was performed.The clinical data of 4 HCL patients who received the treatment of single course CCR regimen in the First Affiliated Hospital of Nanjing Medical University from October 2015 to March 2023 were collected.The short-term efficacy and safety of CCR regimen were summarized,and the survival status of patients was evaluated by using Kaplan-Meier method.Results:All 4 patients were initial-treated classic HCL,including 3 males and 1 female,with a median age of 46 years old(range:41-66 years old).The median follow-up time of 4 patients was 34.5 months(range:4-92 months).Four months after the end of treatment,3 patients achieved complete remission(CR),and 1 patient achieved partial remission(PR);none of 3 CR patients had minimal residual disease.The prognostication of Kaplan-Meier method showed that all 4 patients had progression-free survival and overall survival at 5 years.No serious drug-related adverse events occurred during the treatment process.No infusion response related to rituximab occurred.Two patients developed grade 1 fatigue,1 patient developed grade 2 pneumonia;1 patient developed grade 4 granulocytopenia,3 patients developed grade 4 thrombocytopenia,and no bleeding event occurred;all adverse reactions were controllable.Conclusions:The single course CCR regimen has good efficacy and safety in treating HCL,and it can serve as a new attempt in clinical treatment of HCL.

关 键 词：白血病 多毛细胞 抗肿瘤联合化疗方案 环磷酰胺 克拉屈滨 利妥昔单抗 治疗结果 不良反应 

分 类 号：R733.7[医药卫生—肿瘤]