含利妥昔单抗方案治疗晚期套细胞淋巴瘤临床分析

目的探讨含利妥昔单抗化疗方案治疗晚期套细胞淋巴瘤(MCL)患者临床疗效及预后。方法回顾性分析2011年7月至2021年7月丹东市第一医院收治的42例晚期MCL患者的临床资料,化疗方案中均包括利妥昔单抗。采用MCL国际预后指数(MIPI)评估患者预后,ECOG评分评估患者功能状态,评估治疗疗效、疾病控制率(DCR)、客观缓解率(ORR)及不良反应发生率,采用Kaplan-Meier法评估无进展生存期(PFS)及总生存期(OS),应用Cox回归对筛选的临床特征、分子病理、治疗反应以及预后因素进行分析。结果42例患者中位发病年龄为70岁,其中男性31例、女性11例。27例接受利妥昔单抗联合CHOP方案化疗,6例接受利妥昔单抗联合苯达莫斯汀方案化疗,9例接受利妥昔单抗联合伊布替尼方案化疗。42例晚期MCL的客观缓解率为42.8%,疾病控制率为61.9%,中位OS为63个月(95%CI:50.030~75.930),中位PFS为18个月(95%CI:6.645~29.355)。皮疹和间质性肺炎为最常见的不良反应。结论晚期MCL患者应用含利妥昔单抗方案治疗具有较好的近期疗效,不良反应可耐受。利妥昔单抗联合苯达莫斯汀联合治疗可获得更高的疾病缓解率。

Clinical analysis of terminal mantle cell lymphoma treated with rituximab regimen

Objective To evaluate the clinical efficacy and prognosis of rituximab chemotherapy in patients with mantle cell lymphoma(MCL).Methods The clinical data of 42 patients with advanced MCL admitted to the Dandong First Hospital from July 2011 to July 2021 were analyzed retrospectively.All patients were treated with rituximab.The MCL International Prognostic Index(MIPI)was used to evaluate the prognosis of the patients,the ECOG score was used to evaluate the functional status of the patients,the treatment efficacy,disease control rate(DCR),objective response rate(ORR)and incidence of adverse reactions were evaluated,and the Kaplan-Meier method was used to evaluate the progression free survival(PFS)and overall survival(OS).The clinical features,molecular pathology,treatment response and prognostic factors were analyzed by Cox regression.Results The median age of 42 patients was 70 years old,31 males and 11 females.Twenty-seven patients received rituximab combined with CHOP chemotherapy,6 received rituximab combined with bendamustine chemotherapy,and 9 received rituximab combined with ibrutinib chemotherapy.The objective remission rate of 42 patients with advanced MCL was 42.8%,the disease control rate was 61.9%,the median total survival time was 63 months(95%CI:50.030~75.930),and the median progression free survival(PFS)was 18 months(95%CI:6.645-29.355).Skin rash and interstitial pneumonia were the most common adverse events.Conclusions Treatment with rituximab for advanced MCL has a good short-term effect and tolerable side effects,the disease remission rate of rituximab combined with Bendamustine was better than that of the other two regimens.