摘要
目的探讨美罗华联合GDP方案治疗复发和难治性弥漫大B细胞性淋巴瘤患者的近远期疗效及安全性。方法选取2012年1月至2017年1月期间西京医院和空军第九八六医院血液科收治疗的复发难治性弥漫大B细胞性淋巴瘤患者68例,采用随机数表法将患者分为观察组和对照组,每组34例,对照组患者采用GDP方案化疗(吉西他滨1 000 mg/m2d1、d8,顺铂75 mg/m2d1,地塞米松20~40 mg d1~4,21 d为一个周期) 4~6个疗程,观察组患者采用美罗华联合GDP化疗4~6个疗程,参照《弥漫大B细胞淋巴瘤的评价标准》,结合B超、CT或PET/CT等检查结果,比较两组的疗效和安全性。结果观察组患者的总缓解率和完全缓解率分别为94.12%、82.35%,明显高于对照组的52.94%、67.65%,疾病稳定率与疾病进展率分别为2.94%、2.94%,明显低于对照组的17.65%、14.71%,差异均有统计学意义(P<0.05);全部患者均获随访,随访期间,观察组患者的死亡率为17.65%,明显低于对照组的50.00%,差异有统计学意义(P<0.05);观察组患者的1年总生存率与1年无进展生存率分别为97.06%、85.29%,明显高于对照组的76.47%、58.52%,差异均有统计学意义(P<0.05);两组患者的WBC下降、胃肠道反应、带状疱疹、转氨酶增高、便秘、贫血发生率比较差异均无统计学意义(P>0.05),但观察组患者的畏寒发热发生率为44.12%,而对照组为0,差异有统计学意义(P<0.05);全部患者的不良反应经对症处理后得以有效的缓解。结论美罗华联合GDP化疗治疗复发难治性弥漫大B细胞性淋巴瘤患者的近远期疗效显著,且药物安全性较高,值得临床推广应用。
Objective To investigate the efficacy and safety of mabthera combined with GDP in patients with relapsed and refractory diffuse large B-cell lymphoma. Methods Sixty-eight patients with relapsed and refractory diffuse large B cell lymphoma were selected from Department of Hemopathology, Xijing Hospital and Air Force 986 Hospital during January 2012 and January 2017 were selected, which all were divided into observation group(n=34) and control group(n=34) by random number table. Patients in the control group were treated by GDP regimen(gemcitabine 1 000 mg/m^2, d1, 8, cisplatin 75 mg/m^2, d1, dexamethasone 20-40 mg d1-4, 21 d for a cycle) chemotherapy for 4 to 6 courses. The patients in the observation group were treated with mabthera combined with GDP regimen for 4 to 6 courses. According to the evaluation criteria of diffused large B-cell lymphoma, combined with the results of B-ultrasound,CT or PET/CT, the efficacy and safety of the two groups were compared. Results The overall remission rate and complete remission rate of the patients in the observation group were 94.12% and 82.35%, respectively, which were significantly higher than 52.94% and 67.65% in the control group. The disease stability rate and disease progress rate were2.94% and 2.94% respectively, which were significantly lower than 17.65% and 14.71% in the control group(P<0.05).During the follow-up period, the mortality was 17.65% in the observation group and 50.00% in the control group, respectively(P<0.05). The 1-year overall survival rate and 1-year progress-free survival rate in the observation group were97.06% and 85.29%, respectively, which were significantly higher than 76.47% and 58.52% in the control group(P<0.05). The rates of WBC decline, gastrointestinal tract reaction, herpes zoster, transaminase heighten, constipation, anemia incidence between two groups had no statistically significant difference(P>0.05). The incidence of cold fever in the observation group and the control group was 44.12% and 0 respectively, with statistically signifi
作者
段晓晖
郝彩霞
王健红
唐海龙
刘祥祥
梁蓉
邹晓荣
DUAN Xiao-hui;HAO Cai-xia;WANG Jian-hong;TANG Hai-long;LIU Xiang-xiang;LIANG Rong;ZOU Xiao-rong(Department of Hematology,Xijing Hospital,the First Affiliated Hospital of Air Force Military Medical University,Xi'an 710032,Shaanxi,CHINA;Department of Rheumatology and Immunology,Air Force 986 Hospital,Xi'an 710054,Shaanxi,CHINA)
出处
《海南医学》
CAS
2020年第4期421-424,共4页
Hainan Medical Journal
基金
陕西省科技研究社发攻关项目(编号：2012SF2-24)
2018年度学科助推计划资助项目(编号：XJZT18ML81)
