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硼替佐米联合阿霉素及地塞米松治疗复发难治性套细胞淋巴瘤15例
引用本文:张永清, 石炳毅, 陈协群, 夏永寿, 叶丽萍, 刘丽辉, 施兵. 硼替佐米联合阿霉素及地塞米松治疗复发难治性套细胞淋巴瘤15例[J]. 中国肿瘤临床, 2011, 38(18): 1092-1094. DOI: 10.3969/j.issn.1000-8179.2011.18.009
作者姓名:张永清  石炳毅  陈协群  夏永寿  叶丽萍  刘丽辉  施兵
作者单位:解放军总参谋部总医院血液科 (北京市100091)
摘    要:探讨硼替佐米联合阿霉素、地塞米松组成的PAD(bortezomib、doxorubicin and dexamethasone)方案治疗复发、难治性套细胞淋巴瘤(mantle cell lymphoma,MCL)的疗效及安全性。方法:用PAD方案治疗15例复发、难治性MCL,分析其疗效及影响因素,同时观察不良反应。PAD方案治疗4~6个疗程:硼替佐米(1.3 mg/m2,d1、4、8、11,快速静脉注射)、阿霉素(10 mg/d,d4~6,静脉注射)和地塞米松(40 mg/d,d4~6,口服,每21天为1个疗程)。结果:80%(12/15)患者达PR及PR以上疗效,其中CR 26.7%(4/15,均经PET-CT证实),PR 53.3%(8/15)。无病进展时间(PFS)13.5(3.5~25.1)个月,中位生存时间(OS)35.6(6.3~42.8)个月。PAD方案主要不良反应表现为:Ⅲ~Ⅳ级血小板减少(33.3%),Ⅱ级乏力(26.7%),Ⅱ级周围神经炎(13.3%),带状疱疹病毒感染(20.0%)。结论:PAD方案可有效提高难治性MCL患者疗效,不良反应多轻微可控。

关 键 词:硼替佐米  套细胞淋巴瘤  复发
收稿时间:2011-05-11
修稿时间:2011-07-23

Bortezomib Combined with Doxorubicin and Dexamethasone for Patients with Refractory Senile Mantle Cell Lymphoma
Yongqing ZHANG, Binyi SHI, Xiequn CHEN, Yongshou XIA, Liping YE, Lihui LIU, Bing SHI. Bortezomib Combined with Doxorubicin and Dexamethasone for Patients with Refractory Senile Mantle Cell Lymphoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2011, 38(18): 1092-1094. DOI: 10.3969/j.issn.1000-8179.2011.18.009
Authors:Yongqing ZHANG  Binyi SHI  Xiequn CHEN  Yongshou XIA  Liping YE  Lihui LIU  Bing SHI
Affiliation:1Department of Hematology, General Hospital of Headquarters of the General Staff, PLA, Beijing 100091, China
Abstract:To explore the efficacy and safety of the bortezomib combined with doxorubicin and dexamethasone ( PAD ) regimen in the treatment of refractory/advanced senile mantle cell lymphoma. Methods: The activity and safety of the PAD regimen were investigated in 5 senile patients with refractory/ advanced mantle cell lymphoma. Four to six 21-day cycles of PAD regimen consisted of bortezomib ( 1.3 mg/m2, days 1, 4, 8, and 11 ), doxorubicin ( 10 mg, day 1 ), dexamethasone ( 40 mg, days 1-4 ). Results: Four/five patients achieved ≥PR response, with 2 patients achieving a complete response (also negative for disease activity by positron emission tomography scanning ). Median progression free and overall survival was 12.3 ( 3.5-23.8 ) and 31.8 ( 6.3-41.7 ) months, respectively. The toxic effects of the PAD regimen included grade II thrombocytopenia (2/5), grade IV thrombocytopenia (1/5), grade II neutropenia ( 2/5 ), grade II fatigue ( 1/5 ), grade II peripheral neuropathy ( 1/5 ), herpes zoster ( 1/5 ). Conclusions: Bortezomib combined with doxorubicin and dexamethasone might be a promising therapy, with efficacy and manageable adverse events in senile patients with refractory/advanced mantle cell lymphoma. 
Keywords:Bortezomib  Mantle cell lymphoma  Recurrence
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