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注射用盐酸苯达莫司汀单药治疗利妥昔单抗耐药的B细胞惰性淋巴瘤
引用本文:闵琦,王华庆,钱正子,张会来,周世勇,邱立华,宋拯,赵静,刘霞. 注射用盐酸苯达莫司汀单药治疗利妥昔单抗耐药的B细胞惰性淋巴瘤[J]. 中国肿瘤临床, 2014, 41(19): 1239-1243. DOI: 10.3969/j.issn.1000-8179.20141005
作者姓名:闵琦  王华庆  钱正子  张会来  周世勇  邱立华  宋拯  赵静  刘霞
作者单位:天津医科大学肿瘤医院淋巴瘤科,国家肿瘤临床医学研究中心,天津市肿瘤防治重点实验室(天津市300060)
摘    要:
  目的  观察注射用盐酸苯达莫司汀单药治疗利妥昔单抗耐药的B细胞惰性淋巴瘤临床疗效及安全性。   方法  25例利妥昔单抗治疗失败的B细胞惰性淋巴瘤患者,接受苯达莫司汀单药化疗(120 mg/m2,d1、2,每21天为1个周期),评价其近期疗效、无进展生存期与不良反应。   结果  全组25例患者,共计化疗122个周期,中位5个周期。治疗2个周期后均可评价疗效,其中完全缓解(CR/CRu)6例,部分缓解(PR)13例,稳定(SD)3例,进展(PD)3例,总有效率(ORR)为76%,临床受益率(CBR)为88%。截至随访结束,13例患者出现PFS终点事件,中位疗效持续时间(DOR)8个月,中位无进展生存期(PFS)9个月。各亚组间无进展生存期的关系,主要与骨髓受累、血清LDH水平升高有关,差异有统计学意义(P < 0.05)。常见不良反应为骨髓抑制、胃肠道反应和感染,2例患者出现皮疹,1例患者用药5个周期后发生胃癌。   结论  注射用盐酸苯达莫司汀单药治疗利妥昔单抗耐药的B细胞惰性淋巴瘤可提高疗效,且耐受性良好。 

关 键 词:盐酸苯达莫司汀   B细胞惰性淋巴瘤   利妥昔单抗耐药   疗效   安全性
收稿时间:2014-06-12

Bendamustine hydrochloride in patients with rituximab-refractory indolent B-cell non-Hodgkin's lymphoma
Affiliation:Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
Abstract:
  Objective   To observe the clinical efficacy and toxicities of bendamustine hydrochloride in patients with rituximab-refractory indolent B-cell non-Hodgkin's lymphoma (NHL).   Methods   A total of 25 patients with rituximab-refractory NHL received bendamustine hydrochloride 120 mg/m2 intravenously on days 1 and 2 of the 21-day cycle. The short-term response, progression free survival, and toxicities were evaluated.   Results   The total number of chemotherapy of the 25 patients was 122 cycles, and the median number was 5 cycles. All patients could be evaluated for efficacy. Among the patients, 6 had complete remission, 13 had partial remission, 3 had stable disease, and 3 had progression disease. The overall response rate and clinical benefit rate were 76% and 88%, respectively. Until the deadline, 13 patients had progression disease. The median duration of response was 8 months, and the median progression-free survival (PFS) was 9.3 months. Subgroup analysis showed that PFS is significantly related to bone marrow involvement and serum LDH level (P < 0.05). The main adverse effects were myelosuppression, gastrointestinal reactions, and infection. Rash was found in 2 patients, and 1 case of gastric cancer was discovered after 5 cycles of treatment.   Conclusion  Bendamustine hydrochloride was effective and tolerable in patients with rituximab-refractory indolent B-cell NHL. 
Keywords:
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