CHOP方案联合美罗华治疗弥漫大B细胞淋巴瘤78例回顾性分析

目的 探讨CHOP方案联合美罗华对弥漫大B细胞淋巴瘤患者的影响。 方法 根据治疗方案不同,将2015年1月-2017年12月于台州市第一人民医院血液肿瘤科收治的78例弥漫大B细胞淋巴瘤的患者分成2组,观察组41例,对照组37例。对照组给予CHOP方案化疗:环磷酰胺750 mg/m2,静脉滴注,1次/d,d1;表柔比星50 mg/m2,静脉滴注,1次/d,d1;长春新碱1.4 mg/m2,静脉滴注,1次/d,d1;地塞米松15 mg/m2,静脉滴注,1次/d,d1~5,观察组在对照组基础上联用美罗华375 mg/m2,静脉滴注,1次/d,d0。比较2组患者临床疗效、炎症因子水平以及不良反应情况。 结果 观察组患者显效率(78.05%)明显高于对照组(59.46%),P<0.05。治疗后观察组TNF-α水平明显升高,P<0.05;对照组升高不明显,P>0.05。治疗后2组IL-6、IL-10均较治疗前明显下降,且观察组下降幅度明显大于对照组,均P<0.05。2组患者中性粒细胞减少、血小板减少、恶心/呕吐、乏力、脱发各不良反应发生率组间差异无统计学意义,均P>0.05。 结论 CHOP方案联合美罗华治疗能提高弥漫大B细胞淋巴瘤患者的临床疗效,提高抗炎因子水平同时降低促炎因子表达,安全性与单用CHOP方案治疗差异不显著。 

A retrospective analysis of 78 cases of diffuse large B-cell lymphoma treated with CHOP chemotherapy regimen combined with rituximab

Objective To investigate the effect of CHOP chemotherapy regimen combined with rituximab on diffuse large B-cell lymphoma (DLBCL). Methods A total of 78 patients with DLBCL were divided into two groups according to the different treatment plan:observation group (n=41) and control group (n=37). The control group was given CHOP chemotherapy with cyclophosphamide 750 mg/m2, intravenous drip, 1 times/day, d1; epirubicin 50 mg/m2, intravenous drip, 1 times/day, d1; vincristine 1.4 mg/m2, intravenous drip, 1 times/day, d1; dexamethasone 15 mg/m2, intravenous drip, 1 times/day, d1-5, the observation group based on the control group combined with rituximab 375 mg/m2, intravenous drip, 1 times/day, d0. When compared the clinical curative effect between the two groups, the level of inflammatory factors and adverse reaction conditions. Results The effective rate of TNF-α in the observation group(78.05%) was significantly higher than that in the control group(59.46%), P<0.05. After treatment, the level of TNF-α in the observation group was significantly higher than that in the control group (P<0.05), but the increase in the control group was not significant (P>0.05). The decrease in the observation group was significantly stronger than that in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion CHOP regimen combined with rituximab therapy can improve the clinical efficacy of DLBCL patients, the level of anti-inflammatory factor was increased and the expression of proinflammatory cytokines was decreased. The safety of anti-inflammatory factor was not significantly different from that of CHOP alone, worthy of clinical promotion.