雷那度胺联合GDP方案治疗老年复发难治性T细胞性非霍奇金淋巴瘤的临床疗效

目的:观察雷那度胺联合GDP方案（吉西他滨+顺铂+地塞米松）治疗老年复发难治性T细胞性非霍奇金淋巴瘤（T-NHL）的疗效。方法:收集15例复发难治性T-NHL，给予吉西他滨1 000mg/m2，第1天和第8天；顺铂25mg/m2，第1~3天；地塞米松20mg/m2，第1~5天，21天为1个周期。同时雷那度胺10mg日一次口服，每3周停1周。结果:治疗总有效率73.3%（11/15），其中完全缓解率33.3%（5/15），部分缓解率40.0%（6/15），病情稳定13.3%（2/15），疾病进展13.3%（2/15）；化疗前后B类症状发生率为73.3%vs 26.7%（P=0.021）。1 年无进展生存率（PFS）为46.7%(7/15)，2年PFS为20.0%(3/15)，1年总生存率（OS）66.7%（10/15），2年OS 26.7%(4/15)。不良反应主要为血液学毒性、消化道反应、肝功能损害、皮疹。结论:雷那度胺联合GDP方案是治疗老年复发难治性T-NHL较为安全有效的化疗方案。

Clinical effect of the GDP regimen and lenalidomide combination treatment for elderly patients with relapsed and refractory T cell non-Hodgkin's lymphoma

Objective:To observe the curative effect of the combination of GDP regimen (gemcitabine+cisplatin+dexamethasone) and lenalidomide in the treatment of elderly patients with relapsed and refractory T cell non-Hodgkin's lymphoma (T-NHL).Methods:Fifteen patients with relapsed and refractory T-NHL were collected and treated with gemcitabine 1 000mg/m2,first and eighth days,cisplatin 25mg/m2,1~3 days.Dexamethasone 20mg/m2,1~5 days,21 days for 1 cycle.At the same time,lenalidomide 10mg was taken orally once,drug withdrawal 1 week after 3 weeks.Results:The overall refective rate was 73.3%(11/15),and the complete remission rate was 33.3%(5/15),partial remission rate 40.0%(6/15),stable disease 13.3%(2/15) and disease progression in 13.3%(2/15).The class B symptoms occur rate was 73.3%vs 26.7% before and after chemotherapy (P=0.021),1-year progression free survival (PFS) was 46.7%(7/15),2-year PFS was 20.0%(3/15),1 year overall survival rate (OS) 66.7%(10/15),2 years OS 26.7%(4/15).The main adverse reactions were hematologic toxicity,gastrointestinal reaction,liver function damage,and skin rash.Conclusion:The combination of GDP regimen and lenalidomide is a safe and effective chemotherapy regimen in the treatment for elderly patients with relapsed and refractory T-NHL.