| 改良Hyper-CVAD/MA方案治疗25例淋巴系统恶性肿瘤的临床分析 |
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| 引用本文： | 刘蒙,杨明珍,夏瑞祥,曾庆曙,夏海龙,王永庆. 改良Hyper-CVAD/MA方案治疗25例淋巴系统恶性肿瘤的临床分析[J]. 中国肿瘤临床, 2012, 39(3): 166-169. DOI: 10.3969/j.issn.1000-8179.2012.03.012 |
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| 作者姓名： | 刘蒙 杨明珍 夏瑞祥 曾庆曙 夏海龙 王永庆 |
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| 作者单位： | 安徽医科大学第一附属医院血液内科（合肥市230022） |
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| 摘 要： | 目的 评价改良Hyper-CVAD/MA方案治疗国内成人急性淋巴细胞白血病（ALL）和非霍奇金淋巴瘤（NHL）的疗效及安全性。 方法 对2006年5月至2011年6月接受改良Hyper-CVAD/MA方案治疗的17例成人ALL和8例NHL共25例的疗效和不良反应进行回顾性分析。 结果 25例共完成40个周期A方案与29个周期B方案化疗，1年总体生存（OS）为（61.3±10.2）%。17例ALL 1年OS为（62.6±12.2）%。接受2~4个周期该方案化疗的患者与仅接受1个周期该方案化疗的患者相比，中位OS时间延长（P=0.046）。8例NHL 1年OS为（60.0±18.2）%。接受4~7个周期该方案化疗的患者与接受2个周期该方案化疗的患者相比，中位OS时间延长（P=0.021）。主要不良反应是骨髓抑制及感染，不良反应可控制，B方案的延长并未减低不良反应。 结论 改良Hyper-CVAD/MA方案用于淋巴系统恶性肿瘤的治疗，疗效满意，治疗相关不良反应可控制，值得推广。
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| 关 键 词： | 淋巴瘤 白血病 淋巴样 Hyper-CVAD/MA方案 安全性 疗效 |
| 收稿时间： | 2011-10-23 |
Clinical Analysis of 25 Patients with Lymphoid Malignancies Treated with Modified Hyper-Fractionated Cyclophosphamide, Vincristine, Doxorubicin, and Dexamethasone Alternated with High-Dose Methotrexate and Cytarabine |
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| Meng LIU , Mingzhen YANG , Ruixiang XIA , Qingshu ZENG , Hailong XIA , YongqingWANG. Clinical Analysis of 25 Patients with Lymphoid Malignancies Treated with Modified Hyper-Fractionated Cyclophosphamide, Vincristine, Doxorubicin, and Dexamethasone Alternated with High-Dose Methotrexate and Cytarabine[J]. Chinese Journal of Clinical Oncology, 2012, 39(3): 166-169. DOI: 10.3969/j.issn.1000-8179.2012.03.012 |
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| Authors: | Meng LIU Mingzhen YANG Ruixiang XIA Qingshu ZENG Hailong XIA YongqingWANG |
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| Affiliation: | Department of Hematology, The First Affiliated Hospital of Anhui Medical University, Hefei 230032, China |
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| Abstract: | Objective To evaluate the safety and therapeutic efficacy of a new treatment method for adult acute lymphoblastic leukemia (ALL) and non-Hodgkin's lymphoma (NHL) patients in China. The treatment was a modified regimen of hyper-fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (hyper-CVAD) alternated with high-dose methotrexate and cytarabine (MA). Methods A retrospective analysis was done for 17 ALL and 8 NHL patients treated with the modified hyper-CVAD/MA regimen in the First Affiliated Hospital of Anhui Medical University between May 2006 to June 2011. The relevant safety and efficacy of the treatment regimen were evaluated. Results All 25 patients underwent 40 cycles of the hyper-CVAD regimen and 29 cycles of the MA regimen. The one-year overall survival (OS) rate of the patients reached 61.3% ± 10.2% after the treatments. The one-year OS rate of the 17 adult ALL patients was 62.6% ± 12.2%. Compared with the patients who only received one cycle of the hyper-CVAD/MA regimen, those who underwent two to 4 cycles of the regimen achieved a longer OS rate (P=0.046). The one-year OS rate of the 8 NHL patients was 60.0% ± 18.2%. Compared with the patients who only received two cycles of the regimen, those who received 4 to 7 cycles of the treatment attained a longer OS rate (P=0.021). The major untoward reaction included myelosuppression and infection. However, these toxic side effects were within acceptable limits. Delaying the B cycle could not reduce these side effects. Conclusion The modified hyper-CVAD/MA regimen has a satisfactory therapeutic effect on patients with lymphoid malignancies, and the side effects of the regimen are controllable. |
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