吉西他滨联合奥沙利铂和左旋门冬酰胺酶治疗复发性或难治性非霍奇金淋巴瘤

目的:观察吉西他滨联合奥沙利铂(L-OHP)、左旋门冬酰胺酶(L-ASP)对复发性或难治性进展型非霍奇金淋巴瘤的疗效和不良反应。方法:吉西他滨1000mg/m2,d1,d8,静脉滴注;L-OHP 80mg/m2,d1,d8,静脉滴注;L-ASP 1000 u/d,d1-d8静脉滴注。3-4周为一个化疗周期。20例复发性或难治性进展型非霍奇金淋巴瘤患者,疗程不少于3个周期。结果:20例患者中,14例获得缓解,占77.8%。其中完全缓解(CR)6例,部分缓解(PR)8例。6例具有B类症状的患者中,4例症状消失,1例明显改善,1例无改善。化疗不良作用主要为轻度的胃肠道反应,极少数患者出现严重的骨髓抑制。结论:吉西他滨联合L-OHP、L-ASP对复发性或难治性进展型非霍奇金淋巴瘤有较好的近期疗效,能明显改善患者症状,且大部分患者可以承受其不良反应,是一个值得进一步验证的补救性化疗方案。

Effect of gemcitabine plus oxaliplatin and L-asparaginase (L-ASP) in treatment of relapsed or refractory non-hodgkin's lymphoma

Objective:To evaluate the efficacy and drug-related toxicity of combined gemcitabine,oxaliplatin,and L-asparaginase for the treatment of patients with relapsed or refractory aggressive non-Hodgkin′s lymphoma(NHL).Methods: Twenty patients with histologically confirmed relapsed or refractory aggressive NHL were included in this study.Gemcitabine was given on d1,8 of a three to four weeks schedule at a dose of 1 000 mg/m2 intravenously over 30 minutes for no less than three cycles,and oxaliplatin was given on d1,3 at a dose of 80mg/m2.L-asparaginase was taken orally on d1-8 at a dose of 1000 u/d.Results: Of 20 patients,11 patients(73.3%) showed responses:5 patients(33.3%) complete response and 6 patients(40.0%) partial response.Four patients′ symptoms disappeared,and 1 in 6 patients was alleviated of type B symptoms.Drug-related toxic effects of chemotherapy were mild gastrointestinal reactions in most patients and severe bone marrow depression in very few patients.Conclusion: The present combination of gemcitabine,oxaliplatin,L-asparaginase possesses moderate short-term efficacy,acceptable toxicity,and alleviation of suffering related to the disease.This protocol is worthy to be warranted as salvage for relapsed or refractory aggressive NHL.