维泊妥珠单抗联合化疗对弥漫性大B细胞淋巴瘤患者的疗效  

Efficacy of vepostuzumab combined with R-CHOP in treatment of patients with diffuse large B-cell lymphoma

作　　者：戈亦文 徐文彬[1] 蓝天 林洁 Ge Yi-wen;Xu Wen-bin;Lan Tian;Lin Jie(The Second Ward of General Medicine,Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Pharmacy,Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院全科二病区,上海200025 [2]上海交通大学医学院附属瑞金医院药剂科,上海200025

出　　处：《中国药物应用与监测》2025年第2期252-255,共4页Chinese Journal of Drug Application and Monitoring

摘　　要：目的探讨维泊妥珠单抗联合利妥昔单抗-环磷酰胺、多柔比星、长春新碱和泼尼松方案(rituximabcyclophosphamide,doxorubicin,vincristine,prednisone,R-CHOP)治疗弥漫性大B细胞淋巴瘤患者的疗效以及复发的影响因素。方法将2023年1月至2024年6月上海交通大学医学院附属瑞金医院治疗的弥漫性大B细胞淋巴瘤患者117例采用随机数字表法分成对照组和研究组。对照组患者接R-CHOP方案治疗,研究组患者在对照组基础上加用维泊妥珠单抗。比较两组患者治疗后的临床疗效、免疫功能及不良反应。采用多因素Logistic回归分析疾病复发的影响因素。结果研究组的治疗总有效率86.21%(50/58),高于对照组67.80%(40/59),差异具有统计学意义(χ^(2)=5.584,P=0.018)。治疗后,两组患者的T淋巴细胞、B淋巴细胞、NK细胞数量均低于治疗前,但研究组降低幅度小于对照组(P=0.023)。对照组与研究组不良反应(32.20%vs 29.31%)比较,差异无统计学(χ^(2)=0.214,P=0.644)。多因素Logistic回归分析显示,病理分期Ⅲ期(OR=3.504,95%CI:1.548~7.935)、未合并用药(OR=4.783,95%CI:1.827~12.520)、美国东部肿瘤协作组体能状态评分(ECOG PS)>2分(OR=4.121,95%CI:1.531~11.087)是弥漫性大B细胞淋巴瘤复发的影响因素(P=0.003、0.001、0.005)。结论维泊妥珠单抗联合R-CHOP方案治疗弥漫性大B细胞淋巴瘤患者可以取得较好的疗效。病理分期Ⅲ期、未合并用药、ECOG PS>2分等是影响弥漫性大B细胞淋巴瘤复发的因素。Objective To explore the short-term efficacy of vepostuzumab combined with rituximab-cyclophosphamide,hydroxydoxorubicin,oncovin and prednisone(R-CHOP)in the treatment of patients with diffuse large B-cell lymphoma and the influencing factors of follow-up recurrence.Methods A total of 117 patients treated in Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2023 to June 2024 were selected as the research subjects and divided into 2 groups.The patients in the control group(n=59)were treated with R-CHOP while those in the study group(n=58)were additionally treated with vepostuzumab.The clinical efficacy,immune function and adverse reactions after treatment were compared between the two groups and the influencing factors of relapse during follow-up peroid were analyzed by multivariate Logistic regression.Results The total effective rate of the study group was 86.21%,which was remarkably higher than that of the control((67.80%),χ^(2)=5.584,P=0.018).The number of T lymphocytes,B lymphocytes,and NK cells in both groups was lower after than before treatment,but the decrease in the study group was smaller than that in the control(P=0.023).The incidence of side reactions showed no significant difference between the control group and the study group(32.20%vs 29.31%)(χ^(2)=0.214,P=0.644).Pathological stageⅢ(OR=3.504,95%CI(1.548,7.935)),no combined medication(OR=4.783,95%CI(1.827,12.520)),ECOG PS>2 score(OR=4.121,95%CI(1.531,11.087))were the factors influencing the recurrence of diffuse large B-cell lymphoma(P=0.003,0.001,0.005).Conclusion Vipostuzumab combined with R-CHOP can achieve good short-term efficacy in the treatment of patients with diffuse large B-cell lymphoma,but there is a certain recurrence rate.Pathological stageⅢ,no combination of drugs,and ECOG PS>2 are factors affecting the recurrence of diffuse large B-cell lymphoma during follow-up period.

关 键 词：维泊妥珠单抗 弥漫性大B细胞淋巴瘤 疗效分析 复发 多因素分析 

分 类 号：R733.1[医药卫生—肿瘤]