改良Hyper-CVAD方案治疗前体淋巴母细胞淋巴瘤患者的临床分析

目的 常规化疗方案治疗高度侵袭性的前体淋巴母细胞淋巴瘤效果不佳,该研究评价了改良Hyper-CVAD方案治疗国人前体淋巴母细胞淋巴瘤的疗效和安全性.方法 回顾性分析了2004年6月至2008年6月在中国医学科学院北京协和医学院肿瘤医院肿瘤研究所内科使用改良Hyper-CVAD方案治疗的20例前体淋巴母细胞淋巴瘤患者的结果,对疗效和不良反应进行了评价.结果 截至2009年5月,中位随访17(4～36)个月.20例患者共完成62周期A方案,29周期B方案化疗.共17例可评价疗效,总有效率为88.2%,7例达完全缓解(CR)(41.2%).15例患者采用改良Hyper-CVAD方案作为一线化疗方案(75.0%),一线治疗的有效率为100.0%,CR率为50.0%(7/14).解救治疗的有效率为33%,没有患者达到CR.晚期病变、合并结外受侵是影响Hyper-CVAD方案取得CR的不利因素(P<0.05).主要的不良反应是骨髓抑制,Ⅲ～Ⅳ度粒细胞减少、血小板减少和贫血的发生率分别为95.0%、75.0%和40.0%.全组无治疗相关死亡.结论 改良Hyper-CVAD方案治疗中国前体淋巴母细胞淋巴瘤患者的近期疗效较好,毒性反应在可接受范围内.

A Clinical report on modified Hyper-CVAD regimen in patients with lymphobalstic lymphoma

Objective The efficacy of standard chemotherapy regimen on lymphoblastic lymphoma ( LBL) is unsatisfied. This study was to evaluate the efficacy and safety of modified Hyper-CVAD regimen on Chinese patients with LBL. Methods Clinical records of 20 LBL patients who received modified Hyper-CVAD regimen in Cancer Hospital of Chinese Academy of Medical Sciences, from June 2004 to June 2008, were retrospectively analyzed in terms of response and toxicity. Results By May. 2009, the median follow up time was 17 (4-36) months. The 20 patients totally received 62 cycles regimen A and 29 cycles regimen B. 17 patients were assessable in efficacy, the total response rate (RR) was 88. 2% with complete response (CR) rate of 41. 2%. 15 patients received modified Hyper-CVAD regimen as first-line therapy(75. 0% ) , and RR was 100% with CR rate of 50. 0% (7/14). The RR of salvage therapy was 33% without CR achieved. The major toxicity was myelosuppresion, the incidence of grades 3-4 neutropenia, thrombocytopenia and anemia was 95. 0% , 75. 0% and 40. 0% , respectively. No treatment-related death was observed. Conclusions Modified Hyper-CVAD regimen was a promising regimen for the patients with LBL, and toxicity was within acceptable limits.