美罗华联合化疗治疗B细胞非霍奇金淋巴瘤46例临床分析

目的 探讨美罗华联合化疗治疗B细胞非霍奇金淋巴瘤的临床疗效.方法 选择2004年1月-2009年11月收治于我院的B细胞非霍奇金淋巴瘤患者92例.随机分为观察组(46例)和对照组(46例),观察组采用美罗华联合CHOP化疗治疗,对照组采用单纯CHOP方案化疗,比较两组治疗效果.结果 观察组总有效率89.1%,对照组总有效率88.7%,比较差异有显著性(P<0.05);观察组不良反应7例,对照组发生8例,比较差异无显著性(P>0.05).结论 美罗华联合化疗治疗B细胞非霍奇金淋巴瘤,具有临床疗效好、不良反应少、生存率高等优点.值得推广应用.     

美罗华联合化疗治疗B细胞非霍奇金淋巴瘤46例临床分析

目的 探讨美罗华联合化疗治疗B细胞非霍奇金淋巴瘤的临床疗效.方法 选择2004年1月-2009年11月收治于我院的B细胞非霍奇金淋巴瘤患者92例.随机分为观察组(46例)和对照组(46例),观察组采用美罗华联合CHOP化疗治疗,对照组采用单纯CHOP方案化疗,比较两组治疗效果.结果 观察组总有效率89.1%,对照组总有效率88.7%,比较差异有显著性(P<0.05);观察组不良反应7例,对照组发生8例,比较差异无显著性(P>0.05).结论 美罗华联合化疗治疗B细胞非霍奇金淋巴瘤,具有临床疗效好、不良反应少、生存率高等优点.值得推广应用.     

CHOP联合美罗华治疗B细胞性非霍奇金淋巴瘤的临床研究

目的观察CHOP联合美罗华（R-CHOP）治疗CD20阳性B细胞性非霍奇金淋巴瘤（NHL）的临床疗效及不良反应。方法采用随机对照的方法 ,将72例初治B细胞淋巴瘤患者分R-CHOP组和CHOP组。其中,R-CHOP组36例,采用R-CHOP方案化疗;CHOP组36例,采用CHOP方案化疗。4个疗程后比较2组的临床疗效及不良反应。结果 R-CHOP组完全缓解率77.7%,总有效率91.7%;CHOP组完全缓解率52.7%,总有效率63.9%;2组临床疗效差异有统计学意义（P〈0.05）。2组不良反应差异无统计学意义。结论 R-CHOP方案治疗CD20阳性B细胞性非霍奇金淋巴瘤疗效更好,不良反应无增加。     

利妥昔单抗联合CHOP化疗方案治疗CD20阳性B细胞性非霍奇金淋巴瘤疗效观察

目的观察利妥昔单抗(美罗华)联合CHOP化疗方案治疗CD20阳性B细胞性非霍奇金淋巴瘤的疗效及安全性。方法将23例B细胞非霍奇金淋巴瘤患者随机分为联合组12例和CHOP组11例。联合组采用美罗华联合CHOP方案治疗;CHOP组单用CHOP方案治疗。2组均每3周为1个循环周期,6个周期后观察2组的疗效及不良反应。结果联合组完全缓解率及总有效率略高于CHOP组,但差异均无统计学意义(P>0.05)。随访1年后,联合组无进展生存率及总体生存率略优于CHOP组,但差异均无统计学意义(P>0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。2组所发生的各类不良反应总体严重程度比较差异无统计学意义(P>0.05)。结论美罗华联合CHOP化疗方案治疗CD20阳性B细胞性非霍奇金淋巴瘤的效果略优于CHOP方案,且与CHOP方案不良反应相当,安全性无差异。     

美罗华联合CHOP治疗B细胞性非霍奇金淋巴瘤

目的评价美罗华(Rituximah)联合CHOP(R-CHOP)方案治疗CD20阳性B细胞性非霍奇金淋巴瘤(NHL)的临床疗效及不良反应。方法将60例初治B细胞淋巴瘤患者分为R-CHOP组和CHOP组各30例。R-CHOP组采用R-CHOP方案化疗;CHOP组采用CHOP方案化疗。6个疗程后比较两组的临床疗效及不良反应。结果 R-CHOP组完全缓解率达80%,总有效率90%;CHOP组完全缓解率为60%,总有效率为73.3%,两组疗效差异有统计学意义(P<0.01)。两组不良反应差异无统计学意义(P>0.05)。结论美罗华联合CHOP方案治疗CD20阳性B细胞性非霍奇金淋巴瘤疗效显著,不良反应与单纯化疗相似,可作为该病目前的首选方案。     

美罗华联合化疗治疗B细胞非霍奇金淋巴瘤的疗效评价

目的探讨美罗华联合化疗治疗B细胞非霍奇金淋巴瘤的疗效及临床分析。方法 2008年7月至2012年7月期间,我院诊治的44例B细胞非霍奇金淋巴瘤患者,随机将其分为对照组（单纯化疗）和观察组（美罗华联合化疗）,每组各22例,治疗3个疗程后,对其临床疗效、不良反应,进行观察和比较。结果与对照组相比,观察组的总有效率明显升高,差异有统计学意义（P〈0.05）。治疗期间,两组都没有出现严重的不良反应。结论对于B细胞非霍奇金淋巴瘤患者,美罗华联合化疗的疗效显著,不良反应少,明显改善患者的预后质量,值得临床推广。     

美罗华联合化疗对B细胞非霍奇金淋巴瘤患者临床病理的影响分析

目的观察利妥昔单抗注射液(美罗华)联合化疗治疗B细胞非霍奇金淋巴瘤患者的临床效果。方法 62例B细胞非霍奇金淋巴瘤患者,随机分为观察组和对照组,每组31例,两组患者入院后均给予化疗,观察组患者另外给予美罗华治疗,连续治疗3个周期后观察两组患者的治疗效果和不良反应发生率。结果观察组患者治疗总有效率为90.32%,对照组治疗总有效率为67.74%,组间差异有统计学意义(P<0.05);观察组出现不良反应8例,对照组出现不良反应6例,组间差异无统计学意义(P>0.05)。结论临床上对B细胞非霍奇金淋巴瘤患者采用美罗华和化疗联合治疗,治疗效果理想,且无严重不良反应发生,具有较大的实用价值。     

美罗华联合CHOP方案治疗非霍奇金淋巴瘤的护理

目的探讨美罗华联合CHOP方案治疗B细胞性非霍奇金淋巴瘤的观察及护理方法。方法通过对13例B细胞性非霍奇金淋巴瘤患者使用美罗华联合CHOP方案进行治疗,化疗前给予心理护理,治疗过程中做好不良反应及毒副作用的观察和护理。结果治疗过程中5例出现发热,1例出现过敏反应,13例均出现不同程度的骨髓抑制。结论正确而恰当的护理可预防和减轻美罗华联合CHOP方案治疗的不良反应及毒副作用的发生,保证治疗的顺利进行,提高治疗效果．     

美罗华治疗侵袭性B细胞淋巴瘤疗效观察

目的：探讨美罗华治疗侵袭性B细胞淋巴瘤的临床疗效及优越性。方法：回顾性分析我院78例侵袭性B细胞NHL患者治疗情况,其中39例为观察组采用美罗华联合CHOP化疗方案,39例为对照组采用CHOP化疗方案,观察两组近期疗效及不良反应情况,并进行对比分析。结果：观察组CR率和有效率（CR＋PR）率分别为79.49%和92.31%,明显高于对照组的53.85%和64.10%,组间比较差异有统计学意义（P〈0.05）;两组不良反应发生率比较差异无统计学意义（P〉0.05）。结论：含美罗华的联合化疗方案可提高侵袭性B细胞淋巴瘤治疗的临床疗效,且不会增加其不良反应,是目前侵袭性B细胞淋巴瘤治疗的一种较佳方案,值得临床推广应用。     

B细胞性非霍奇金淋巴瘤利妥昔单抗联合CHOP方案治疗效果

目的 观察利妥昔单抗联合CHOP方案治疗B细胞性非霍奇金淋巴瘤的疗效及不良反应.方法 将38例患者随机分为治疗组21例与对照组17例;治疗组予利妥昔单抗联合CHOP方案治疗,对照组予CHOP方案治疗,观察分析疗效、不良反应.结果 治疗组总有效率为81.0％,高于对照组41.1％,差异有统计学意义（P＜0.05）;2组不良反应比较差异无统计学意义（P＞0.05）.结论 利妥昔单抗联合CHOP方案治疗B细胞性非霍奇金淋巴瘤的临床效果较好.     

利妥昔单抗对于非霍奇金淋巴瘤的治疗及其药物经济学

目的:阐述利妥昔单抗对于非霍奇金淋巴瘤的疗效和药物的不良反应,并尝试探讨其药物经济学。方法:借鉴国外的研究并结合本院血液科对于这方面的探索,采用非传统的药物经济学模式来评价利妥昔单抗的治疗方案。结果:从药物经济学的角度而言,利妥昔单抗联合环磷酰胺 多柔比星(阿霉素) 长春新碱 泼尼松(CHOP)方案治疗非霍奇金淋巴瘤较传统单用CHOP方案优势明显。结论:利妥昔单抗具有较好的疗效和安全性,也是治疗非霍奇金淋巴瘤较经济的方法。     

Rituximab: a review of its use in non-Hodgkin's lymphoma and chronic lymphocytic leukaemia

Rituximab is an anti-CD20 monoclonal antibody that has demonstrated efficacy in patients with various lymphoid malignancies, including indolent and aggressive forms of B-cell non-Hodgkin's lymphoma (NHL) and B-cell chronic lymphocytic leukaemia (CLL). While the optimal use of the drug in many clinical settings has yet to be clarified, two pivotal trials have established rituximab as a viable treatment option in patients with relapsed or refractory indolent NHL, and as a standard first-line treatment option when combined with cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) chemotherapy in elderly patients with diffuse large B-cell lymphoma (the most common type of aggressive NHL). The former was a noncomparative trial in relapsed indolent NHL (follicular and small lymphocytic subtypes) with clinical responses achieved in about half of patients treated with rituximab 375 mg/m(2) intravenously once weekly for 4 weeks, which was similar to some of the most encouraging results reported with traditional chemotherapeutic agents. The latter was a randomised comparison of eight cycles of CHOP plus rituximab 375 mg/m(2) intravenously (one dose per cycle) versus CHOP alone in previously untreated elderly patients (60 to 80 years of age) with diffuse large B-cell lymphoma. In this pivotal trial, 2-year event-free and overall survival were significantly higher with rituximab plus CHOP, and there was no increase in clinically significant adverse effects compared with CHOP alone. Treatment with rituximab is generally well tolerated, particularly in terms of adverse haematological effects and serious or opportunistic infections relative to standard chemotherapy. Infusion-related reactions occur in the majority of patients treated with rituximab; these are usually mild to moderate flu-like symptoms that decrease in frequency with subsequent infusions. In approximately 10% of patients, however, severe infusion-related reactions develop (e.g. bronchospasm, hypotension). These reactions are usually reversible with appropriate interventions and supportive care but there have been rare reports of fatalities. CONCLUSIONS: Clinical trials with rituximab indicate that the drug has broad application to B-cell malignancies, although further clarification is needed to determine its optimal use in many of these clinical settings. Importantly, rituximab in combination with CHOP chemotherapy has emerged as a new treatment standard for previously untreated diffuse large B-cell lymphoma, at least in elderly patients. Compared with conventional chemotherapy, rituximab is associated with markedly reduced haematological events such as severe neutropenia, as well as associated infections. Rituximab may be particularly suitable for elderly patients or those with poor performance status, and its tolerability profile facilitates its use in combination with cytotoxic drugs. PHARMACODYNAMIC PROPERTIES: Rituximab is a mouse/human chimaeric IgG(1)-kappa monoclonal antibody that targets the CD20 antigen found on the surface of malignant and normal B lymphocytes. Although treatment with rituximab induces lymphopenia in most patients, typically lasting about 6 months, a full recovery of B lymphocytes in the peripheral blood is usually seen 9-12 months after therapy, as CD20 is not expressed on haematopoietic stem cells. CD20 is, however, expressed on >90% of B-cell non-Hodgkin's lymphomas (NHL) and to a lesser degree on B-cell chronic lymphocytic leukaemia (CLL) cells.Although not fully elucidated, the cytotoxic effects of rituximab on CD20-positive malignant B cells appears to involve complement-dependent cytotoxicity, complement-dependent cellular cytotoxicity, antibody-dependent cellular cytotoxicity and induction of apoptosis. In addition, in vitro data indicate that rituximab sensitises tumour cells to the effects of conventional chemotherapeutic drugs. PHARMACOKINETIC PROPERTIES: Serum rituximab concentrations increased in proportion to dose across a wide range of single- and multiple-dose intravenous regimens in patients with B-cell NHL. When administll NHL. When administered at a dose of 375 mg/m(2) once weekly for 4 weeks in a pivotal trial in patients with relapsed or refractory indolent B-cell NHL (follicular or small lymphocytic subtypes), peak serum concentrations essentially doubled from the first (239.1 mg/L) to the fourth (460.7 mg/L) infusion, while elimination half-life (t(1/2)) increased from 76.3 to 205.8 hours (3.2 to 8.6 days). The concomitant increase in serum rituximab concentrations and t(1/2) with each successive infusion may be due, at least in part, to the elimination of circulating CD20-positive B cells and reduction or saturation of CD20-binding sites after the initial infusions of rituximab. The pharmacokinetic properties of rituximab are also characterised by wide inter-individual variability, and serum drug concentrations that are correlated with clinical response. Although pharmacokinetic data are limited in patients with aggressive forms of NHL, such as diffuse large B-cell lymphoma, rituximab appears to have a similar pharmacokinetic profile in these patients to that in patients with indolent B-cell NHL. The pharmacokinetics of rituximab are also reported to be similar whether the drug is administered with or without cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) chemotherapy. THERAPEUTIC USE: A number of studies have demonstrated efficacy of intravenous rituximab in patients with various lymphoid malignancies of B-cell origin, including indolent (e.g. follicular lymphoma) and aggressive (e.g. diffuse large B-cell lymphoma) forms of NHL, and CLL, but the drug has not yet been approved for use in CLL, and approved indications in NHL vary between countries. In the US, for example, rituximab is available for the treatment of patients with low-grade or follicular, relapsed or refractory, CD20-positive B-cell NHL. In Europe, the drug has similar approval for relapsed or refractory follicular NHL as in the US, but has also been approved for use in combination with CHOP chemotherapy for the most common aggressive form of NHL (CD20-positive, diffuse large B-cell lymphoma). Rituximab was approved for these indications primarily on the basis of results from two pivotal trials. In Japan, rituximab has been approved for indolent B-cell NHL and mantle cell lymphoma (an aggressive form of B-cell NHL), primarily on the basis of results of a Japanese phase II trial. Indolent NHL: Results of several studies evaluating rituximab 375 mg/m(2) once weekly for 4 weeks in patients with indolent forms of B-cell NHL (primarily follicular and small lymphocytic lymphomas) showed objective response (OR) rates ranging from approximately 40-60% in those receiving the drug for relapsed or refractory indolent B-cell NHL, and slightly higher (50-70%) for those receiving rituximab as first-line therapy. In a pivotal trial in 166 patients with relapsed or refractory low-grade or follicular B-cell NHL, intent-to-treat (ITT) analysis showed an OR rate of 48%, and a projected median time to progression of 13 months.Encouraging data are also emerging on the use of rituximab in combination with chemotherapeutic agents (e.g. CHOP, fludarabine-containing regimens) or other drugs (e.g. interferon-alpha2a) in previously untreated patients with indolent forms of B-cell NHL (primarily follicular and small lymphocytic subtypes). Rates for OR were consistently around 95%, with the majority being complete responses (CRs). Follow-up data from a study in 40 patients with low-grade or follicular B-cell NHL treated with rituximab plus CHOP as first-line therapy showed that responses were durable with a progression-free survival and median duration of response >5 years.Bcl-2 gene rearrangement (t14;18) occurs in malignant cells in up to 85% of patients with follicular lymphoma, and minimal residual disease in peripheral blood and bone marrow can be monitored using polymerase chain reaction (PCR). In several studies assessing blood and/or bone marrow, rituximab has achieved molecular response (conversion from PCR-positive to PCR-negative bcl-2 status) in at least half of the patients. Aggressive NHL: Studies with rituximab as monotherapy in aggressive B-cell NHL, a potentially curable disorder, have generally been restricted to patients with relapsed or recurrent disease, since CHOP has traditionally been the standard first-line treatment regimen. However, promising results from phase II monotherapy studies prompted further clinical investigation of rituximab in conjunction with chemotherapy. Thus, most studies with rituximab in patients with aggressive forms of B-cell NHL have involved combination therapy, including a pivotal randomised trial comparing eight cycles of standard CHOP therapy plus rituximab 375 mg/m(2) (one dose per cycle) versus CHOP alone in 399 previously untreated elderly patients (60-80 years of age) with diffuse large B-cell lymphoma. Results of the pivotal trial showed a clear advantage for rituximab plus CHOP versus CHOP in terms of event-free survival (primary endpoint) at 2 years (57% vs 38%, p < 0.001). Overall survival at 2 years (70% vs 57%, p < 0.01) and CR rate (76% vs 63%, p < 0.01) were also higher with the rituximab-CHOP combination. Other, smaller trials with rituximab in combination with CHOP or other chemotherapeutic regimens, either as first-line therapy or for patients with relapsed or refractory aggressive B-cell NHL, have also shown promising results in terms of clinical response rates.CLL: In relatively small trials (n < 40) conducted primarily in patients with relapsed or refractory B-cell CLL, rituximab monotherapy (various regimens) achieved OR rates of 23-45%, with median duration of response ranging from approximately 3-10 months. (ABSTRACT TRUNCATED)     

Rituximab: a review of its use in non-Hodgkin's lymphoma and chronic lymphocytic leukaemia

Rituximab (MabThera, Rituxan) is an anti-CD20 monoclonal antibody that induces lysis and apoptosis of normal and malignant human B cells, and sensitises malignant B cells to the cytotoxic effect of chemotherapy. In phase III trials in patients with indolent or aggressive B-cell non-Hodgkin's lymphoma (NHL), intravenous rituximab in combination with chemotherapy was more effective as first- or second-line therapy than chemotherapy alone in providing tumour remission and patient survival. Likewise, in patients with chronic lymphocytic leukaemia (CLL), rituximab in combination with chemotherapy appeared more effective than chemotherapy alone as either first- or second-line treatment. In addition, rituximab maintenance therapy was shown to significantly prolong tumour remission and patient survival in patients with indolent B-cell NHL or CLL. The combination of rituximab with cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) was cost effective as first-line therapy for advanced-stage diffuse large B-cell NHL compared with CHOP alone. Rituximab, either alone or in combination with chemotherapy, was generally well tolerated in patients with NHL or CLL. Overall, rituximab in combination with chemotherapy, is a valuable option for first- and second-line therapy in patients with advanced-stage indolent or aggressive B-cell NHL, and possibly those with B-cell CLL, and is included in current treatment guidelines for these indications. The drug is also potentially useful as maintenance therapy in patients with indolent B-cell NHL or CLL.     

利妥昔单抗联合CHOP 方案治疗B 细胞型非霍奇金淋巴瘤的疗效评价

目的评价利妥昔单抗联合CHOP方案治疗B细胞型非霍奇金淋巴瘤的疗效。方法选择我院2006年1月～2006年12月64例B细胞型非霍奇金淋巴瘤患者,随机分为对照组和实验组,每组32例,实验组患者给予利妥昔单抗联合CHOP方案治疗,对照组患者仅给予单纯CHOP方案治疗。治疗后随访6～60个月,通过比较两组患者的治疗有效率,不良反应的发生率以及1年、3年和5年的生存率评价疗效。结果实验组治疗有效率为78.13%,显著高于对照组(50.0%);随访6～60个月后,实验组1、3、5年生存率分别是81.25%、50.0%、12.5%,而对照组1、3、5年生存率分别是68.75%、34.38%、0.0%,实验组1、3、5年生存率均显著高于对照组(P<0.05);两组患者治疗过程中均出现白细胞降低、恶心呕吐、脱发、肝功能损害、贫血的不良反应,但发生率无显著性差异。结论利妥昔单抗联合CHOP方案治疗B细胞型非霍奇金淋巴瘤疗效显著优于单用CHOP方案,且不良反应的发生率没有上升,值得临床进一步的研究和推广。     

R-CHOP方案治疗弥漫性大B细胞淋巴瘤疗效分析

目的:探讨弥漫性大B细胞淋巴瘤采用R-CHOP方案治疗的临床效果。方法:将某院收治的80例弥漫性大B细胞淋巴瘤患者按照随机数字表法分为研究组(R-CHOP方案)与对照组(CHOP方案);对比两组治疗效果及安全性。结果:治疗后研究组总有效率较对照组高,淋巴瘤国际预后指数优于对照组(P<0.05);两组不良反应结果对比无统计学意义(P>0.05)。结论:弥漫性大B细胞淋巴瘤采用R-CHOP方案治疗的效果更为理想。