改良ProMACE-CytaBOM方案治疗复发、难治侵袭性NHL的疗效评价

目的评价改良ProMACE-CytaBOM方案治疗复发、难治侵袭性NHL的疗效及安全性。方法回顾性分析2005年5月至2010年9月期间，我院收治的27例复发、难治性侵袭性淋巴瘤患者，其中男19例，女8例，中位年龄47（15～74）岁；均采用改良ProMACE-CytaBOM方案；21天为1周期。结果27例患者均可评价疗效，总有效率51.8%（完全缓解率22.2%）。中位无进展生存期为7月，中位总生存期为19月。B细胞、LDH正常NHL患者中位无进展生存期长于T细胞、LDH高者，差异均有统计学意义（P＜0.05）。B细胞、IPI≤2、LDH正常的NHL患者中位总生存期长于T细胞、IPI＞2、LDH高者，差异均有统计学意义（P＜0.05）。不良反应主要有Ⅱ～Ⅲ度血液学毒性及Ⅰ～Ⅱ度非血液学毒性，6例并发轻度感染，经一般抗生素治疗可控制。结论ProMACE-CytaBOM改良方案治疗复发、难治侵袭性NHL疗效肯定，不良反应可耐受，值得进一步研究。

Evaluation of Modified ProMACE-CytaBOM Regimen in Treating Relapsed or Refractory Patients with Aggressive NHL

Objective To evalute the efficacy and safety of modified ProMACE-CytaBOM regimen for relapsed or refractory patients with aggressive NHL.Methods Twenty-seven patients with relapsed or refractory NHL from May 2005 to September 2010 were retrospectively analyzed.They were 19 male and 8 female patients with meadian age of 47 years(range 15 to 74) years old.All patients were treated by modified ProMACE-CytaBOM cycles were repeated every 21 days.Results The overall response rates of all patients were 51.9%(CR 22.2%).The median progression-free survival(PFS) was 7 months and the median overall survival(OS) was 19 months.The median PFS was longer in subgroups patients with B-cell and normal LDH NHL than that in those with T-cell and elevated serum LDHNHL.The median OS was longer in subgroups patients with B-cell,IPI≤2 and normal LDH than that in those with T-cell,IPI>2 and elevated serum LDHNHL.The major side effects were Ⅱ～Ⅲ grades of bone marrow suppression and Ⅰ～Ⅱ grades of non-myeloid toxicities.Conclusion Modified ProMACE-CytaBOM showed promising activity and acceptable toxicity in relapsed and refractory patients with aggressive NHL.However further investigation was required.