| 利妥昔单抗相关间质性肺炎的临床分析 |
| |
| 引用本文： | 吕慧娟,董玲,李维,侯芸,宋拯,李兰芳,邱立华,钱正子,周世勇,刘贤明,王华庆,张会来,付凯.利妥昔单抗相关间质性肺炎的临床分析[J].中国肿瘤临床,2016,43(7):291-297. |
| |
| 作者姓名： | 吕慧娟 董玲 李维 侯芸 宋拯 李兰芳 邱立华 钱正子 周世勇 刘贤明 王华庆 张会来 付凯 |
| |
| 作者单位： | 作者单位:①天津医科大学肿瘤医院淋巴瘤内科,中美淋巴血液肿瘤诊治中心,国家肿瘤临床医学研究中心,天津市肿瘤防治重点实验室(天津市300060);②天津市人民医院肿瘤诊治中心 |
| |
| 摘 要： | 目的:分析B 细胞非霍奇金淋巴瘤（B cell non-Hodgkin's lymphoma ，B-NHL）患者行化疗或免疫化疗后发生间质性肺炎（interstitial pneumonia ，IP ）与美罗华（利妥昔单抗注射液）的相关性，并分析IP 发生的临床特征。方法:回顾性分析天津医科大学肿瘤医院2010年1 月至2015年5 月期间266 例初治CD20+B-NHL患者的病例资料，将所有病例分为美罗华联合化疗组和单纯化疗组，分析IP 的发生与美罗华使用之间的关系，及其相关的临床特点。结果:化疗联合美罗华组中IP 的发生率9.6%（13/ 135）较单纯化疗组2.3%（3/ 131）高（P < 0.05），与IP 发生相关的临床特征包括老年、男性、初诊时淋巴细胞计数高于正常值、既往糖尿病史、病理亚型为弥漫性大B 细胞性淋巴瘤（diffuse large B-cell lymphoma，DLBCL ）；淋巴细胞绝对值超过正常范围（HR= 14.685，95%CI:3.137～63.234，P = 0.001）、糖尿病（HR= 8.811，95%CI:1.907～40.720，P = 0.005）、病理亚型为DLBCL （HR= 0.078，95%CI:0.012～0.489，P = 0.006）及美罗华的使用（HR= 6.769，95%CI:1.359～33.710，P = 0.020）是其发生的独立危险因素。多数患者无明显症状，不需要特殊处理。结论:美罗华可导致IP 的发生，可能与免疫力的降低及真菌感染相关，激素冲击疗法联合或不联合抗真菌治疗能取得良好的疗效。
|
| 关 键 词： | B 细胞非霍奇金淋巴瘤? 利妥昔单抗? 间质性肺炎? 危险因素? 治疗 |
| 收稿时间： | 2015-11-15 |
Clinical analysis of rituximab-induced interstitial pneumonia |
| |
| Affiliation: | 1Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, The Sino-US Center for Diagnosis and Treatment on Lymphoma and Leukemia, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China; |
| |
| Abstract: | Objective:To identify whether the use of rituximab predisposed to interstitial pneumonia (IP) after treatment of B cell non-Hodgkin's lymphoma (B-NHL) with the chemotherapy and immunochemothrapy and to assess the clinical features and treatment of IP. Methods:A clinical study was conducted on 266 cases of CD20+B-NHL patients with CHOP-like or RCHOP-like therapeutic regimen from January 2010 to May 2015. The cases were divided into rituximab-containing chemotherapy group and chemotherapy group. We analyzed the relationship between the development of IP and the use of rituximab. The IP related clinical features were also reviewed. Results:The incidence of IP in the rituximab-containing chemotherapy group was significantly higher compared with the incidence in the chemotherapy group. The IP-related factors include age>60, male, elevated absolute lymphocyte count (ALC), diabetes, and dif-fuse larpe B-cell lymphoma (DLBCL) subtype. By multivariate analysis, elevated ALC, diabetes, DLBCL subtype, and addition of ritux-imab were revealed as significant factors for an elevated risk of IP. Conclusion:The incidence of IP was higher in patients with CD20+B-NHL receiving rituximab-containing chemotherapy;this result may be related to immune disorders. Corticosteroids and antifungal ther-apy can effectively relieve the patients' symptoms. |
| |
| Keywords: | B cell non-Hodgkin's lymphoma rituximab interstitial pneumonia risk factor treatment |
| 本文献已被 万方数据 等数据库收录！ |
| 点击此处可从《中国肿瘤临床》浏览原始摘要信息 |
|
点击此处可从《中国肿瘤临床》下载全文 |
|
