利妥昔单抗联合调整剂量EPOCH方案治疗胃肠道弥漫大B细胞淋巴瘤的可行性观察

目的:分析与探讨利妥昔单抗联合调整剂量EPOCH方案治疗胃肠道弥漫大B细胞淋巴瘤的可行性.方法:选取累及胃肠道的弥漫大B细胞淋巴瘤患者26例,分析发病经过、临床特点、病理特点以及预后判断,运用利妥昔单抗联合调整剂量的EPICH(R-DA-EPOCH)治疗方案进行治疗,观察化疗后的治疗反应并随访转归情况.结果:本次研究中3例接受R-DA-EPOCH方案治疗后得到了良好治疗结果.结论:采取利妥昔单抗联合调整剂量EPOCH方案治疗胃肠道弥漫大B细胞淋巴瘤具有一定可行性,近期疗效良好,但本次研究样本量过少,需将样本量扩大对远期疗效进行判断.     

利妥昔单抗联合化疗治疗弥漫大B细胞淋巴瘤19例护理体会

目的总结利妥昔单抗联合化疗治疗弥漫大B细胞淋巴瘤的护理方法与价值。方法将时间段2015年1月至2015年6月期间,我院住院部所确诊并纳入治疗的弥漫大B细胞淋巴瘤患者作为研究对象,共19例。本组19例患者均采取利妥昔单抗联合化疗治疗方法。在用药治疗期间对患者实施针对性护理干预。对本组19例患者经利妥昔单抗联合化疗治疗的整体效果进行判定,并对治疗期间不良反应的发生情况进行统计观察。结果本组19例弥漫大B细胞淋巴瘤患者经利妥昔单抗联合治疗的有效率为94.74%(18/19)。治疗期间,共4例患者出现不良反应,不良反应总发生率为21.05%(4/19)。结论利妥昔单抗联合化疗治疗弥漫大B细胞淋巴瘤患者的临床效果确切,治疗期间不良反应以药物过敏、静脉炎、胃肠道反应、以及骨髓抑制为主。通过实施针对性护理干预,能够显著降低不良反应发生率,对提高用药安全性有积极价值。     

利妥昔单抗治疗弥漫大B淋巴瘤的毒副作用及其护理

目的：探讨利妥昔单抗治疗弥漫大 B 淋巴瘤的毒副作用及其护理。方法选取安徽医科大学第一附属医院肿瘤内科2012年7月—2013年12月收治的32例弥漫大 B 淋巴瘤患者,给予利妥昔单抗联合 CHOP 化疗,观察疗效及根据毒副作用给予的针对性护理结果。结果32例患者中3例患者在治疗期间因病情发展而停止应用利妥昔单抗治疗,退出研究,有效率为58.62％;毒副作用发生率为82.76％。结论临床上应用利妥昔单抗治疗肿瘤时,其毒副作用发生率较高,应充分评估其可能发生的毒副作用,针对毒副作用可能带来的风险,制定护理措施。     

利妥昔单抗治疗弥漫大B细胞淋巴瘤疗效观察

目的探讨利妥昔单抗治疗弥漫大B细胞淋巴瘤的临床效果。方法选择2005年2月至2008年2月符合入选条件的弥漫大B细胞淋巴瘤患者64例,分为对照组与观察组,对照组给予CHOP化疗方案,观察组给予利妥昔单抗联合CHOP化疗方案,观察2组总有效率及不良反应。结果观察组总有效率为84.38%;对照组总有效率为59.38%,2组差异有统计学意义（χ^2=4.947,P〈0.05）。结论利妥昔单抗能提高弥漫大B细胞淋巴瘤的治疗效果,且不良反应无明显增加。     

利妥昔单抗治疗B细胞濑巴现状

抗CD20单抗利妥昔单抗(rituximab)是治疗B细胞非霍奇金淋巴瘤(B-NHL)的单克隆抗体药物.文章介绍利妥昔单抗单药治疗、联合其他化疗药物治疗以及靶向放射免疫治疗B细胞非霍奇金淋巴瘤的疗效,研究提示,利妥昔单抗与其他化疗药物联合应用治疗B-NHL具有增效或协同作用,可显著提高疗效,延长缓解期.     

利妥昔单抗联合CTOP方案治疗弥漫大B细胞淋巴瘤的临床观察

目的观察利妥昔单抗(Rituximab)联合CTOP方案治疗弥漫大B细胞淋巴瘤的临床疗效及不良反应。方法 36例弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)患者分为联合组和CTOP组。联合组18例,采用CTOP方案(环磷酰胺加吡喃阿霉素加长春新碱加泼尼松)加利妥昔单抗(375mg/m2,于每周期化疗前1d静脉滴注1次)治疗;CTOP组18例,单用CTOP方案化疗。两组均每21d为一个周期,6周期后评价的疗效及不良反应,随访观察生存情况。结果联合组完全缓解率(CR)为55.6%,总有效率为88.9%;CTOP组分别为38.9%,61.1%,两组疗效差异有统计学意义(P<0.05).联合组1年总生存率(OS)为83.5%,2年OS为71.3%;CTOP组分别为78.3%,41.2%;两组患者的2年OS有显著性差异(P<0.05)。两组患者不良反应主要为轻中度骨髓抑制和胃肠道反应,不良反应发生率相近(P>0.05),均可耐受。结论利妥昔单抗联合化疗治疗弥漫型大B细胞淋巴瘤的临床缓解率较高,患者耐受良好且生存时间较长,应推荐作为首选方案。     

利妥昔单抗治疗B细胞淋巴瘤现状

抗CD20单抗利妥昔单抗（rituximab）是治疗B细胞非霍奇金淋巴瘤（B-NHL）的单克隆抗体药物。文章介绍利妥昔单抗单药治疗、联合其他化疗药物治疗以及靶向放射免疫治疗B细胞非霍奇金淋巴瘤的疗效，研究提示，利妥昔单抗与其他化疗药物联合应用治疗B-NHL具有增效或协同作用，可显著提高疗效，延长缓解期。     

美罗华联合化疗治疗肠道弥漫大B细胞淋巴瘤15例临床分析

目的分析美罗华联合化疗治疗肠道弥漫大B细胞淋巴瘤的疗效及不良反应。方法对选取的15例肠道弥漫大B细胞淋巴瘤患者采用美罗华联合CTNP方案化疗,每21天为1周期,观察疗效及不良反应。结果15例美罗华联合化疗治疗的患者完全缓解12例,部分缓解2例,死亡1例。结论美罗华联合化疗治疗肠道DLBCL疗效较好,治疗过程中注意不良反应,及时调整剂量。     

美罗华治疗B细胞性非霍奇金淋巴瘤临床观察

目的观察利妥昔单抗（美罗华）联合CHOP方案治疗非霍奇金淋巴瘤的疗效及毒副反应。方法9例经病理组织学证实为CD20阳性的B细胞非霍奇金淋巴瘤患者接受利妥昔单抗375mg／m^2,静脉滴注,每3周1次。共4～6次。其间联用CHOP方案治疗4—6个疗程。结果9例患者治疗后,完全缓解6例,部分缓解2例,无变化1例,总有效率88．9％。所有患者均未见严重的不良反应。结论利妥昔单抗联合CHOP方案治疗B细胞非霍奇金淋巴瘤临床疗效较好,毒副反应较小。     

利妥昔单抗联合沙利度胺维持治疗老年弥漫大B细胞淋巴瘤的疗效评价

目的评价利妥昔单抗联合沙利度胺维持治疗老年弥漫大B细胞淋巴瘤(Diffuse large B cell lymphoma,DLBCL)的有效性及安全性。方法回顾性分析甘肃省武威肿瘤医院血液科使用R-CHOP方案化疗后完全缓解的≥60岁的DLBCL患者86例,按其治疗方案分为2组。对照组患者在完全缓解后单用利妥昔单抗维持治疗(n=43);治疗组患者应用利妥昔单抗联合沙利度胺方案维持治疗(n=43例)。对两组患者的预后进行分析。结果治疗组4年、5年总生存期(OS)率高于对照组(P<0.01);3年、4年、5年无进展生存期(PFS)率高于对照组(P<0.01);治疗组总生存时间、无进展生存时间明显长于对照组(P<0.001)。结论利妥昔单抗联合沙利度胺维持治疗老年人DLBCL,可延长患者总生存时间及无进展生存时间,无严重不良反应发生。     

美罗华联合CTNP方案治疗高龄B细胞非霍奇金淋巴瘤疗效观察

目的探讨美罗华联合CTNP方案治疗高龄非霍奇金淋巴瘤的疗效及毒副反应。方法 6例经病理证实为B细胞非霍奇金淋巴瘤高龄患者采用美罗华联合CTNP方案化疗。每3周为1个周期。观察患者治疗过程中及其后的毒副反应和疗效。结果 6例高龄患者完全缓解4例,部分缓解2例,1年总生存率83.33%。毒副反应均可耐受,主要是骨髓抑制和输液相关的不良反应。结论美罗华联合CTNP方案是治疗高龄B细胞非霍奇金淋巴瘤的一种有效方案,完全缓解率高且毒副反应小。     

利妥昔单抗联合化疗及造血干细胞移植治疗难治性弥漫大B细胞淋巴瘤临床观察

目的 探讨利妥昔单抗联合化疗及造血干细胞移植治疗难治性弥漫大B细胞淋巴瘤(DL-BCL)的临床疗效和安全性评价.方法 回顾性分析1例应用利妥昔单抗联合化疗及造血干细胞移植治疗的难治性DLBCL患者的临床资料,并结合文献复习对此方法治疗难治性DLBCL的临床疗效和安全性进行评价.结果 1例难治性DLBCL患者先后予各种方案化疗后未获得缓解,改为利妥昔单抗联合化疗及造血干细胞移植治疗后,造血重建顺利,取得完全缓解,相关并发症控制较好,随访至2010年11月1日一直长期无病生存.结论 利妥昔单抗联合化疗及造血干细胞移植治疗难治性DLBCL是安全有效的治疗手段.

Abstract：

Objective To report the clinical efficacy and safety of rimximab combined with autologous hematopoietic stem cell transplantation in a case of refractory diffuse large B cell lymphoma.Methods Clinical data of a case in rituximab combined chemotherapy and hematopoietic stem eell transplantation for refractory difluse large B cell lymphonm was analyzed.The efficacy and safety for the program with literature review were evaluated.Results The patient did not achieve remission with various chemotherapy regimens.After using autologous hematopoietic stem cell translplantation with rituximab,the hematopoietic was rebuilded successfuly,symptoms were complete reIieved,complications wero well controlled.Follow-up to November 1,2010,tIle patient was discasc-free survival.Conclusion Rituximab combined with autologous hematopoietie stem cell transplantation is a safe and effective treatment of refractory diffuse large B cell lymphoma.     

Complete remission of primary bilateral adrenal lymphoma achieved by Rituximab-CHOP chemotherapy

Primary adrenal lymphoma (PAL) is an exceedingly rare disease. Because of its rareness, uncertain etiology, variable duration of survival, unremarkable clinical presentations and unsatisfied therapeutic strategies, its treatment has always been unsatisfactory. Here we report a 50-year-old male patient with primary bilateral adrenal diffuse large B-cell lymphoma. He was treated with surgery followed by combined chemotherapy using R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone). He achieved complete remission after 3 cycles of chemotherapy. At present, he is considered free of tumor at 3 years after chemotherapy. Our case report demonstrates that patients with primary bilateral adrenal diffuse large B-cell lymphoma may achieve a good outcome using R-CHOP chemotherapy. To the best of our knowledge, our patient who achieved complete remission after R-CHOP chemotherapy has had the longest survival as published in the literature.     

利妥昔单抗联合化疗治疗弥漫性大B细胞淋巴瘤的临床观察

目的：评价利妥昔单抗联合化疗治疗弥漫性大B细胞淋巴瘤（DLBCL）的疗效及安全性.方法：116例DLBCL患者接受利妥昔单抗联合化疗方案,中位治疗4.73个疗程.初治DLBCL患者112例,其中R-CHOP 87例,R-CHOP样29例;26例在化疗中进展.采用Cheson标准及WHO标准评估疗效及不良反应.结果：116例患者全部进行疗效评价,总体客观有效率为75％ （87/116）,CR ＋CRu为34例（29.31％）,PR为53例（45.69％）,SD为12例（10.34％）,PD为17例（14.66％）.其中1例患者在挽救方案获得缓解后,接受自体干细胞支持下的超大剂量化疗.主要不良反应为骨髓抑制,消化道反应,轻度肝损伤,首次输注反应2例.中位随访52.3（3.2～86.5）月,6例死于肿瘤进展,2例死于骨髓抑制后合并重度感染.中位生存期60.54月（3.2～86.5）,其中1、3、5年总生存率分别为81％、63％、52％,无病生存期1、3、5年总生存率分别为76％、52％、47％.在影响疗效相关因素分析中,IPI评分Ann、Arbor分期和LDH水平为影响患者化疗效果的相关因素（P＜0.05）.结论：利妥昔单抗联合治疗DLBCL的疗效确切,不良反应可以耐受,效果与文献报道一致.     

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。     

R-CHOP和CHOP方案治疗早期原发性胃弥漫大B细胞淋巴瘤的疗效和毒性比较

目的探讨R-CHOP方案治疗早期原发性胃弥漫大B细胞淋巴瘤的临床疗效及不良反应。方法回顾性分析和比较采用R-CHOP方案（16例）以及CHOP方案（16例）治疗的初治早期（Ⅰ～Ⅱ期）胃弥漫大B细胞淋巴瘤患者的近期疗效及不良反应。结果 R-CHOP组患者化疗后CR8例,PR6例,SD1例,PD1例,有效率为87.5%（14/16）;CHOP组患者化疗后CR6例,PR5例,SD2例,PD3例,有效率为68.7%（11/16）,R-CHOP组有效率高于CHOP组（P〈0.05）。两组的不良反应主要为骨髓抑制、感染、粘膜炎、胃肠道反应、发热、肝功能损害。神经毒性及过敏反应等,经对症治疗后都能较快缓解,两组的不良反应发生率差异无统计学意义。结论 R-CHOP方案治疗早期胃弥漫大B细胞淋巴瘤的临床疗效优于CHOP方案,不良反应无明显差异。     

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)     

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.     

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.