联合化疗治疗复发和难治性恶性淋巴瘤

应用ＥＰＩＭ（异环磷酰胺、ＶＰ－１６、强的松和米托蒽醌）联合治疗２０例恶性淋巴瘤。其中２例ⅢＡ型、１例ⅢＢ型、６例ⅣＡ型和１１例ⅣＢ型。患者经ＥＰＩＭ联合化疗后，５例完全缓解，７例部分缓解，５例无变化和３例恶化。其毒副作用主要表现为脱发、感染及血液和消化系统，但均为轻度和中度，仅１例患者因严重血小板减少，颅内出血而死亡。

Salvage Regimen with A Combination of Ifosfamide,VP-16 Mitoxantrone and Prednisone for Relapsed and Resistant Malignant Lymphoma

The management of patients with relapsed and resistant malignant lymphoma for physicians is a serious problem. Recently we have treated 20 patients with relapsed and resistant lymphoma using a combination chemotherapy of VP-16,prednisone,ifosfamide and mitoxantrone(EPIM).The EPIM regimen was as follows:MXT 2-4mg/m2 i.v. on day 1,3,5;VP-16 100mg/m2 i.v. on day 1; prednisone 40-60mg/d on days 1-5;ifosfamide 1.5g/m2 i.v. on days l,3-5 along with MESNA. Cycles were repeated every 21 days. After treatment 5 patients achieved CR,7 patients PR,5 and 3 patients achieved NC(no change)and PD(progression of the disease)respectively. Of the 14 relapsed patients,3 and 6 patients got CR and PR respectively. Of the 6 resistant patients 2 patients gotcRand IPR. These 20 patients received 66 courses ofchemotherapy totally(mean 3.3, range 2-6).The predominant toxicity and side effects included alopecia,infection,haematological and digestivetoxicity. All the toxicity was well tolerated by the patients except 1 case died of the severity of the disease. In conclusion the combination therapy of EPIM to relapsed and resistant lymphoma not only produced a better resuIt but also was welI tolerated.