美罗华治疗32例弥漫型大B细胞性非何杰金氏淋巴瘤

目的 评价美罗华治疗弥漫型大B细胞性非何杰金氏淋巴瘤DLBCL的临床效果及不良反应。方法 用同期对照的前瞻性研究方法,将68例弥漫型大B细胞性NHL患者分为研究组(美罗华组)和对照组,前组32例用CHOP方案(环磷酰胺、阿霉素、长春新碱和强的松)联合美罗华治疗;后组36例单用CHOP方案。每4周循环1个疗程,3～6疗程后作评价。将两组患者按国际淋巴瘤预后因子指数(IPI)分为中低危组和高危组,分析其疗效与预后。全部患者6个疗程后停止治疗,随访观察生存情况。结果 美罗华组完全缓解率(CR)达56.3％,总有效率87.5%;对照组分别为13.9％、63.9%,两组疗效差异有统计学意义(P<0.001)。美罗华组6、12、24、36月总的生存率分别为96.9％、87.5％、71.9％和65.6％,对照组分别为91.7％、80.6％、58.3％和41.7％(P>0.05)。美罗华组中中低危组的CR及部分缓解率(PR)分别为68.4％、26.3％,高危组分别为38.5%、38.5％(P<0.01);对照组中低危组的CR及PR分别为15.8％、68,4％,高危组则分别为11.8％、29.4％(P<0.001)。结论 美罗华联合CHOP方案治疗DLBCL的疗效显著,3年生存率高,不良反应较单纯化疗少,可作为该病目前的首选方案。

The therapeutic effects of Rituximab on 32 diffuse large B cell non-Hodgkin lymphoma cases

OBJECTIVE To evaluate the therapeutic effects and side - effects of Rituximab on diffuse large B cell non - Hodgkin lymphoma (DLBCL). METHODS A prospective study with concurrent control group was applied. 68 cases with DLBCL were divided into 2 groups. The 32 cases in research group (Rituximab group) were administered Rituximab combined with CHOP (cyclophosphamide, doxombicin, vin-cristine, and prednisone) regimen. The remaining 36 cases in the control group were treated with CHOP regimen only. All cases were received a course of chemotherapy every 4 weeks and were evaluated after 3-6 courses. The two groups can be stratified into high - risk and low - intermediate - risk subgroups according to the international prognosis index (IPI). Then we analyzed the relationship between the effects and IPI. All cases were discontinued therapy after 6 courses and were followed up the observation of survival condition. RESULTS The complete remission (CR) rate and total response rate in Rituximab group were 56.3% and 87.5% respectively, while those corresponding rates in control group were 13.9% and 63.9% , respectively. The therapeutic differences between two groups showed statistical significance( P < 0.001). The overall survival rates in Rituximab group after 6,12,24 and 36 months were 96.9%, 87.5%,71.9% and 65.5 % respectively, while those in control group were 91.7%, 80.6% ,58.3% and 41.7% respectively. The CR rate and partial remission (PR) rate of the high - risk and low - intermediate - risk subgroups in Rituximab group were 68.4 % , 26.3 % and 38.5 % , 38.5 % respectively ( P < 0.01), and the CR rate and PR rate of the high-risk and low - intermediate - risk subgroups in control group were 15.8 % , 68.4 % and 11.8 % , 29.4 % respectively ( P < 0.001) .CONCLUSION Comparing with CHOP regimen chemotherapy, Rituximab combined CHOP regimen showed higher therapeutic effects and 3 - year overall survival rate. The side - effects in the Rituximab group were no worse than those in the control group. Rituximab combined CHOP regimen should be the first choice in treating DLBCL.