摘要
目的:探讨含苯达莫司汀方案治疗滤泡性淋巴瘤(FL)的有效性、安全性及相关预后因素。方法:收集2020年1月1日-2022年10月30日在连云港市第二人民医院与江苏省人民医院血液科应用含苯达莫司汀方案治疗的129例FL患者的临床资料。将患者分为苯达莫司汀联合利妥昔单抗(BR)组、苯达莫司汀联合奥妥珠单抗(GB)组、利妥昔单抗+环磷酰胺+表柔比星/多柔比星+长春地辛+泼尼松(R-CHOP)组,回顾性分析苯达莫司汀为基础的方案治疗FL的疗效、安全性及相关预后因素。结果:BR组、GB组与R-CHOP组的ORR分别为98%、94%、72.3%,CR率分别为61.2%、70%、40.4%,R-CHOP组的ORR率、CR率与BR组、GB组均具有统计学差异(P<0.05)。BR组、GB组与R-CHOP组的3年PFS率分别为89.6%、90.9%、48.9%,具有统计学差异(P<0.05),但3年OS无统计学差异(P>0.05)。血液学不良反应主要为骨髓抑制,淋巴细胞及CD4^(+)T淋巴细胞在用药后6个月降至最低,且BR组与GB组淋巴细胞减少的发生率高于R-CHOP组,具有统计学差异(P<0.05);非血液学不良反应发生率较高的依次为肺部感染、EB病毒感染、乙肝病毒再激活、胃肠道反应,均可控,组间比较无统计学差异(P>0.05)。CD4^(+)T淋巴细胞计数ROC曲线示,BR组判断感染的AUC为0.802,临界值为258/uL;GB组判断感染的AUC为0.754,临界值为322/uL。结论:含苯达莫司汀方案治疗FL疗效佳,且不良反应可控,但治疗后淋巴细胞减少明显且与不同CD20单抗联合使用时表现出差异性。CD4^(+)T淋巴细胞计数最低值可以作为含苯达莫司汀方案治疗FL感染发生及疗效的预测因素。
Objective:To investigate the effectiveness,safety,and related prognostic factors of the treatment of follicular lymphoma(FL)with a regimen containing Bendamustine.Methods:The clinical data of 129 FL patients who were treated with Bendamustine containing regimen were collected from January 1,2020 to October 30,2022 in the Hematology Department of Lianyungang Second People′s Hospital and Jiangsu Provincial People′s Hospital.The patients were divided into three groups:Bendamustine plus Rituximab(BR),Bendamustine plus Obinutuzumab(GB),Rituximab+Cyclophosphamide+Epirubicin/Doxorubicin+Vindesine+Prednisone(R-CHOP).The efficacy,safety and related prognostic factors of the treatment of FL with a regimen based on Bendamustine were retrospectively analyzed.Results:The ORR was 98%for the BR group,94%for the GB group,and 72.3%for the R-CHOP group,while the CR rate was 61.2%,70%and 40.4%,respectively.The ORR and CR rates of the R-CHOP group were statistically different from those of the BR group and GB group(P<0.05).The 3-year PFS rate of the BR group,GB group,and R-CHOP group was 89.6%,90.9%,48.9%,respectively.There was a statistically significant difference in 3-year PFS between the R-CHOP group,BR group,and GB group(P<0.05),while there was no statistically significant difference in 3-year OS(P>0.05).Hematological adverse reactions were mainly bone marrow suppression.Lymphocytes and CD4^(+)T lymphocytes decreased to the lowest level about 6 months after treatment,and the incidence of lymphopenia in BR group and GB group was higher than that in R-CHOP group,with a statistical difference(P<0.05).The higher incidence of non-Hematological adverse reactions were pulmonary infection,EB virus infection,hepatitis B virus reactivation,and gastrointestinal reactions without statistical difference in 3 groups(P>0.05),and were all controllable.The Receiver operating characteristic of CD4^(+)T lymphocyte count showed that AUC of BR group was 0.802,and the critical value was 258/uL;AUC of GB group was 0.754 with a critical value of 3
作者
李金莲
庄万传
柴星星
LI Jin-Lian;ZHUANG Wan-Chuan;CHAI Xing-Xing(Lianyungang Clinical Institute of Bengbu Medical College;Department of Hematology,Lianyungang Second People′s Hospital Affiliated to Kangda College of Nanjing Medical University,Lianyungang 222000,Jiangsu Province,China)
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2024年第3期708-717,共10页
Journal of Experimental Hematology
基金
连云港市卫生科技项目(QN202207)
南京医科大学康达学院基金课题重点项目(KD2022KYJJZD037)。
