利妥昔单抗联合CHOP方案治疗弥漫大B细胞淋巴瘤临床疗效

目的：观察利妥昔单抗联合 CHOP 方案治疗弥漫大 B 细胞淋巴瘤（DLBCL）的临床疗效。方法：分析39例2006年1月-2012年6月我院住院确诊为 DLBCL 患者的临床资料，所有患者均采用 R - CHOP 方案治疗，每3周1疗程，共4-6疗程。结果：39例患者中16例获完全缓解（ CR），CR 率为41.0%，12例获部分缓解（ PR），PR 率为30.8%，总有效率（CR ＋ PR）为71.8%（28/39），好转（MR）和无变化（NC）各4例（10.3%），疾病进展（PD）3例（7.7%）；单因素分析发现，CR 及 PR 率与性别、年龄、ECOG 评分、结外病变数目无关（P ﹥0.05）。但与临床分期、LDH 水平、β2- MG 水平、B 细胞来源（ GCB 型、Non - GCB 型）及有无大包块病变有关（均 P ﹤0.05），患者28个月的无进展生存时间（PFS）和总生存时间（OS）分别为（54.8±5.2）%和（65.4±5.7）%。结论：利妥昔单抗联合 R - CHOP 方案治疗弥漫大 B 细胞淋巴瘤近期疗效好，不良反应轻微，可作为该病的一线治疗方案。

Effect of rituximab combined with CHOP chemotherapy in the treatment of diffused large B cell lymphoma Xu Shufen,Bai Hai,Wang Cunbang,Zhang Qian,Xi Rui,Zhou Jinmao,Pan Yaozhu,Chen Yan

To observe the cilinical effect of rituximab combined with CHOP chemotherapy in the treat-ment of diffuse large B - cell lymphoma. Methods：The cilinical data of 39 patients with diffuse large B - cell lympho-ma who were followed up in our hospital from 2006 to 2012 were analyzed. All patients received R - CHOP regimen of 4 - 6 cycles. Results：In all 39 patients,16（41. 0% ）complete responese（CR）and 12（30. 8% ）partial response （PR）were observed,the total response rate（CR ＋ PR）was 71. 8%（28 / 39）,four patients（10. 3% ）got better and 4 （10. 3% ）remained stable,3（7. 7% ）experienced progression. By univariate analysis the parameters including clinical stage,LDH levels,β2 - Mg levels,original B - cell（GCB or Non - GCB）and bulky disease could affect the therapeu-tic effect. But gender,age,ECOG score and number of extranodal diseases had no significant effects on clinical effica-cy（P ﹥ 0. 05）. The 28 - mouth progression - free survival（PFS）and overall survival（OS）were（54. 8 ± 5. 2）% and （65. 4 ± 5. 7）% ,respectively. Conclusion：R - CHOP regimen has high efficacy with mild toxicity in the treatment of diffuse large B - cell lymphoma,R - CHOP regimen can be used as the first line chemotherapy.