西达本胺联合DICE方案治疗复发/难治弥漫大B细胞淋巴瘤的疗效和生存分析  

Efficacy and Survival Analysis of Chidamide Combined with DICE Regimen in Patients with Relapsed/Refractory Diffuse Large B-Cell Lymphoma

作　　者：武莉丽[1] 史俐 李炜静 刘玮 封云 殷少宁 何翠颖[1] 刘丽宏[1] WU Li-Li;SHI Li;LI Wei-Jing;LIU Wei;FENG Yun;YIN Shao-Ning;HE Cui-Ying;LIU Li-Hong(Department of Hematology,The Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,Hebei Province,China)

机构地区：[1]河北医科大学第四医院血液内科,河北石家庄050011

出　　处：《中国实验血液学杂志》2025年第2期373-378,共6页Journal of Experimental Hematology

基　　金：2021年度河北省医学适用技术跟踪项目(GZ2021010)。

摘　　要：目的:观察西达本胺联合DICE方案(顺铂+异环磷酰胺+依托泊苷+地塞米松)治疗复发/难治性弥漫大B细胞淋巴瘤(R/R DLBCL)患者的疗效和安全性。方法:回顾性分析2016年10月至2020年10月在河北医科大学第四医院血液内科接受西达本胺联合DICE方案治疗的31例R/R DLBCL患者的临床资料,观察临床疗效及不良反应。结果:31例患者中,男性20例,女性11例,中位年龄为55(27-71)岁。年龄<60岁患者21例,≥60岁患者10例。26例为难治患者,5例为复发患者。生发中心型(GCB)13例,非生发中心型(non-GCB)17例,1例患者Hans分型缺失。双表达(DEL)患者17例,非双表达(non-DEL)患者14例。治疗后完全缓解率为38.7%(12/31),总有效率为67.7%(21/31)。中位疾病无进展生存时间为9.8个月(95%CI:4.048-15.552),中位总生存时间为13.9个月(95%CI:9.294-18.506)。多因素分析结果显示,GCB、DEL两个因素降低R/R DLBCL患者的疾病复发风险。主要3/4级血液学不良反应为血小板减少、粒细胞缺乏、贫血、白细胞减少。结论:西达本胺联合DICE方案治疗R/R DLBCL疗效较好,治疗后需严密监测血液学不良反应。Objective:To investigate the efficacy and safety of chidamide combined with DICE regimen(cisplatin+ifosfamide+etoposide+dexamethasone)for relapsed/refractory diffuse large B-cell lymphome(R/R DLBCL).Methods:The clinical data of 31 R/R DLBCL patients treated by chidamide combined with DICE regimen in the Hematology Department of the Fourth Hospital of Hebei Medical University from October 2016 to October 2020 were retrospectively analyzed.The clinical efficacy and adverse events were observed.Results:Among the 31 patients,20 were male and 11 were female.The median age of the patients was 55(range:27-71)years old,21 cases were<60 years old,10 cases were≥60 years old.26 cases were refractory and 5 cases were relapsed.There were 13 cases of germinal center B-cell like(GCB),17 cases of non-GCB,and 1 case had missing Hans type.There were 17 cases of double-expression lymphoma(DEL)and 14 cases of non-DEL.The complete response rate of patients was 38.7%(12/31),the overall response rate was 67.7%(21/31).The median progression-free survival time and the median overall survival time were 9.8(95%CI:4.048-15.552)months,13.9(95%CI:9.294-18.506)months,respectively.Multipvariate analysis showed that GCB and DEL reduced the risk of disease recurrence in R/R DLBCL patients.The main grade 3/4 hematological adverse events in this study were thrombocytopenia,agranulocytosis,anemia and leukopenia.Conclusion:The chidamide combined with DICE regimen is effective in the treatment of R/R DLBCL,and hematological adverse events should be closely monitored.

关 键 词：复发/难治 弥漫大B细胞淋巴瘤 双表达 西达本胺 疗效 不良反应 

分 类 号：R733.1[医药卫生—肿瘤]