| 一例难治性慢性淋巴细胞白血病患者的循证治疗 |
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| 引用本文： | 张丽,向兵,王双,李颖,刘玉霞.一例难治性慢性淋巴细胞白血病患者的循证治疗[J].中国循证医学杂志,2011,11(4):464-467. |
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| 作者姓名： | 张丽 向兵 王双 李颖 刘玉霞 |
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| 作者单位： | 1. 四川大学华西医院血液内科,成都,610041
2. 四川大学华西医院老年医学科,成都,610041 |
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| 摘 要： | 目的采用循证实践的方法指导难治性慢性淋巴细胞白血病(chronic lymphocytic leukemia,CLL)的临床治疗。方法针对1例CLL患者的病情,计算机检索Cochrane图书馆(2010年第10期)、OVID、PubMed(1992.1～2010.10)、美国国家综合癌症网络网站(http://www.nccn.org/)等循证医学的三级文献数据库,查找高质量临床证据,并根据患者意愿为患者制定最佳治疗方案。结果共纳入2个RCT,5个CCT。现有临床证据显示:①对于难治性CLL,美罗华(利妥昔单抗)能进一步改善联合化疗的疗效。②对于氟达拉滨耐药的CLL,COP/CHOP方案仍然有效。③造血干细胞移植仍为复发/难治CLL的有效挽救治疗方案,但尚无依据支持其成为一线选择。采用美罗华联合CHOP方案治疗该患者,停化疗2月后复查显示病情缓解,目前仍在随访中。结论现有证据表明美罗华联合CHOP方案耐受性好,疗效优于单用CHOP方案,本例临床实践结果也显示接受美罗华联合CHOP方案的患者的预后较好,但仍需高质量证据进一步验证。
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| 关 键 词： | 难治性慢性淋巴细胞白血病 利妥昔单抗 循证治疗 |
Evidence-Based Treatment for a Patient with Refractory Chronic Lymphocytic Leukemia |
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| ZHANG Li,XIANG Bing,WANG Shuang,LI Ying,LIU Yu-xia.Evidence-Based Treatment for a Patient with Refractory Chronic Lymphocytic Leukemia[J].Chinese Journal of Evidence-based Medicine,2011,11(4):464-467. |
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| Authors: | ZHANG Li XIANG Bing WANG Shuang LI Ying LIU Yu-xia |
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| Institution: | ZHANG Li1,XIANG Bing1*,WANG Shuang2,LI Ying2,LIU Yu-xia1 1.Department of Hematology,West China Hospital,Sichuan University,Chengdu 610041,China,2.Department of Geriatrics |
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| Abstract: | Objective To apply the evidence-based treatment method to direct the clinical therapy of refractory chronic lymphocytic leukemia(CLL).Methods Such evidence-based medicine databases as The Cochrane Library(Issue 10,2010),OVID database,PubMed(January 1992 to October 2010) and http://www.nccn.org/ were searched to find the clinical evidence with high quality and the optimum treatment was designed based on the patient's preferences.Results Two RCTs and five CCTs were included.The available clinical evidence dis... |
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| Keywords: | Refractory chronic lymphocytic leukemia Rituximab Evidence-based treatment |
| 本文献已被 CNKI 维普 万方数据 等数据库收录！ |
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