DHAOx方案治疗难治性或复发性非霍奇金淋巴瘤的临床观察

目的:观察DHAOx方案治疗难治性或复发性非霍奇金淋巴瘤的临床疗效及毒副反应。方法:21例患者接受DHAOx方案(奥沙利铂(L-OHP)130mg.m-2静脉滴入3h,d1;阿糖胞苷(Ara-C)2g.m-2静脉滴入,d2,每12h1次;地塞米松(DXM)20～40mg.d-1静脉滴入,d1～4;21～28d为1个周期)治疗。2周期后评价疗效和毒副反应。结果:完全缓解4例(19.0%),部分缓解8例(38.1%),疾病稳定6例(28.6%),疾病进展3例(14.3%),总有效率为57.1%。主要毒副反应为:Ⅲ～Ⅳ级中性粒细胞下降占33.3%(7/21);Ⅲ～Ⅳ级血小板下降占14.3%(3/21);Ⅰ～Ⅱ级腹泻33.3%(7/21),Ⅲ～Ⅳ级腹泻4.8%(1/21);Ⅰ～Ⅱ度外周神经毒性占81.0%(17/21),无Ⅲ～Ⅳ级外周神经毒性发生;Ⅰ～Ⅱ级恶心、呕吐38.1%(8/21),无Ⅲ～Ⅳ级恶心、呕吐反应;Ⅰ～Ⅱ级肝功能损害19.0%(4/21),无肾功能损害及Ⅲ～Ⅳ级肝功能损害。结论:DHAOx方案治疗难治性或复发性非霍奇金淋巴瘤有效性较高,毒副反应可耐受。

Study of DHAOx Regimen for Relapsed or Refractory Non-Hodgkin's Lymphoma

OBJECTIVE： To observe the clinical efficacy and toxic reaction of DHAOx regimen in the treatment of relapsed or refractory non-Hodgkin＇ s lymphoma （NHL）. METHODS： 21 patients with relapsed or refractory NHL were treated with DHAOx regimen （intravenous dripping of dexamethasone （DXM） 20-40 mg.d^-1 from the first day to the forth day; intravenous dripping of cytarabine （Ara-C） 2 g·m^-2 every 12 hours on the second day; intravenous dripping of oxaliplatin （L-OHP） 130 mg·m^-2 for 3 h on the first day）. The therapeutic efficacy and toxic reaction were evaluated after 2 treatment cycles. RESULTS： There were 4 cases of complete remission （19.0%）, 8 cases of partial remission （38.1%）, 6 cases of stable condition（28.6% ）, 3 cases of progressive disease （14.3%）. The total effective rate was 57.1%. Main toxic reaction was Ⅲ-Ⅳivdegree neutropenia （33.3%, 7/21）, Ⅲ-Ⅳdegree thrombocytopenia （14.3%, 3/21）, Ⅰ - Ⅱdegree diarrhea （33.3%, 7/21）, Ⅲ-Ⅳ degree diarrhea （4.8%, 1/21）, Ⅰ - Ⅱ degree peripheral neurotoxicity （81.0%, 17/21）, Ⅰ - Ⅱ degree nausea and vomit （38.1%, 8/21） and Ⅰ - Ⅱ degree hepatic function disorder （ 19.0 %, 4/21 ） without the occurrence of Ⅲ-Ⅳ degree acute peripheral neurotoxicity, Ⅲ-Ⅳ degree nausea and vomit ,Ⅲ-Ⅳ degree hepatic function disorder or renal function disorder. CONCLUSION： DHAOx regimen is effective in the treatment of refractory or relapsed NHL. The toxicity is acceptable.