来那度胺维持治疗在一线治疗缓解后弥漫大B细胞淋巴瘤患者中的应用  

Application of lenalidomide maintenance therapy in diffuse large B-cell lymphoma patients after first-line treatment response

作　　者：黄德鸿 李岱阳 项颖 李玉侠 HUANG Dehong;LI Daiyang;XIANG Ying;LI Yuxia(Blood Tumor Center,Chongqing University Cancer Hospital,Chongqing 400030,China;Shanghai Tissue Bank Precision Medicine Co.,Ltd.,Shanghai 201318,China)

机构地区：[1]重庆大学附属肿瘤医院血液肿瘤中心,重庆400030 [2]上海荻硕贝肯生物科技有限公司,上海2013180

出　　处：《癌症进展》2024年第17期1891-1895,1899,共6页Oncology Progress

基　　金：中国抗癌协会淋巴瘤科研基金(CORP-117)。

摘　　要：目的探讨来那度胺维持治疗在一线治疗缓解后弥漫大B细胞淋巴瘤(DLBCL)患者中的应用效果。方法将一线治疗后缓解的166例DLBCL患者依据是否采用来那度胺维持治疗分为观察组105例和对照组61例。观察组采用来那度胺维持治疗,对照组未采用维持治疗。比较观察组和对照组患者的临床特征、生存情况、治疗期间静脉血栓栓塞(VTE)及心血管疾病发生率。依据深静脉超声诊断结果将观察组患者分为VTE组(22例)和非VTE组(83例)。比较VTE组和非VTE组患者的临床特征和生存情况。结果观察组和对照组患者年龄、经济情况、DLBCL类型、国际预后指数(IPI)分层、首次乳酸脱氢酶(LDH)、最终疗效以及心血管疾病发生情况比较,差异均有统计学意义(P﹤0.05)。观察组和对照组患者1、2年生存率比较,差异均无统计学意义(P﹥0.05)。观察组患者VTE和心血管疾病发生率均明显高于对照组,差异均有统计学意义(P﹤0.01)。VTE组与非VTE组患者年龄、来那度胺维持治疗剂量及疗程比较,差异均有统计学意义(P﹤0.05)。非VTE组患者1年生存率高于VTE组,差异有统计学意义(P﹤0.05)。结论来那度胺维持治疗可以改善一线治疗缓解后DLBCL患者的疗效,临床需在治疗早期关注并加强管理VTE及心血管疾病。Objective To investigate the application effect of lenalidomide maintenance therapy in diffuse large Bcell lymphoma(DLBCL)patients after first-line treatment response.Method A total of 166 patients with DLBCL after first-line treatment response were divided into observation group(105 cases)and control group(61 cases)according to whether lenalidomide maintenance treatment was used.Observation group received lenalidomide maintenance treatment,control group did not receive maintenance treatment.The clinical characteristics,survival,incidences of venous thromboembolism(VTE)and cardiovascular disease were compared between the observation group and the control group.According to the diagnosis results of deep vein ultrasound,the observation group was divided into VTE group(22 cases)and non-VTE group(83 cases).The clinical characteristics and survival were compared between the VTE group and the non-VTE group.Result There were statistically significant differences in age,economic status,DLBCL type,international prognostic index(IPI)stratification,lactate dehydrogenase(LDH)for the first time,final efficacy and cardiovascular disease between observation group and control group(P<0.05).There were no significant differences in 1-year and 2-year survival rates between observation group and control group(P>0.05).The incidences of VTE and cardiovascular disease in observation group were significantly higher than those in control group,the differences were statistically significant(P<0.01).There were significant differences in age,lenalidomide maintenance dose and course of treatment between VTE group and non-VTE group(P<0.05).The 1-year survival rate of non-VTE group was higher than that of VTE group,and the difference was statistically significant(P<0.05).Conclusion Lenalidomide maintenance treatment can improve the efficacy of DLBCL patients after first-line treatment response.Clinical attention and management of VTE and cardiovascular disease should be strengthened in the early stage of treatment.

关 键 词：弥漫大B细胞淋巴瘤 来那度胺 维持治疗 静脉血栓栓塞 

分 类 号：R733.4[医药卫生—肿瘤]