DICE作为二线方案治疗难治或复发性非霍奇金淋巴瘤

目的:观察DICE作为二线方案治疗难治或复发性非霍奇金淋巴瘤(NHL)有效性及不良反应耐受性。方法:采用DICE方案治疗28例复发或难治性非霍奇金淋巴瘤。其中,复发组16例,难治组12例并探讨足三里穴位封闭或粒细胞集落刺激因子(G-CSF)预防化疗对造血系统的抑制作用。结果:28例中,完全缓解CR7例(25.0%),部分缓解PR8例(28.6%),有效率53.6%。复发组的有效率明显高于难治组(10/16比4/12;P<0.01)。乳酸脱氢酶(LDH)升高12例中CR2例,LDH正常组16例CR5例,有显著性差异(P<0.01)。DICE方案的不良反应主要表现为恶心呕吐、脱发和可逆性骨髓抑制,患者均能耐受,无1例出现治疗相关性死亡。结论:DICE方案对复发性NHL有效,但对难治性NHL相对无效,提示复发性和难治性NHL可能有不同的生物学行为,对两者应该选择不同的治疗措施,LDH可以作为NHL化疗是否敏感的指标之一。

DICE Regime as the Second for Refractory or Relapsed Non-Hodgkin's Lymphoma

Objective:To explore ef fi ciency and toxicity of DICE regimen as second-line chemotherapy in refractory o r relapsed non-Hodgkin's lymphoma.Methods:28patients for refrac-tory or re lapsed non-Hodgkin's lymphoma were treated by DICE regimen.Blocking acupunctu re points of Zusanli with dexamethasone or granulocyte colony-stimulating facto r (G-CSF)against myelosupression induced by chemotherapy.Results:A complete response was seen in7patients(25.0%),and a partial response was noted in8patients(28.6%).A significantly higher response rate was seen in pat ients with relapsing non-Hodgkin lymphoma compared with those who failed to ac hieve a complete response with the last chemotherapy(13/16vs.2/12;P <0.01).Low response rate for high LDH group compared to that in normal gr oup.Toxicity was nausea/vomiting,alope-cia and reversible myelosuppression .All the patients can tolerance the side effects and there was one drug-relate d death associated with myelotoxicity.Conclusion:DICE regime was a relatively safe and highly efficient salvage for relapsed but not refractory NHL,this s uggested the there may be different biology character between both them and dif ferent strategies should be provided for them.LDH may be marker for sensitive chemotherapy.