剂量调整的BEACOP方案治疗淋巴瘤不良反应分析

目的 研究剂量调整的BEACOP(DA-BEACOP)方案用于预后不良淋巴瘤患者的不良反应.方法 对2002年8月至2012年2月间接受1次以上DA-BEACOP方案化疗的89例预后不良淋巴瘤患者发生的治疗相关性不良反应进行回顾性分析,方案组成:CHOP方案联合依托泊苷和(或)博来霉素,有或无利妥昔单抗.结果 74例(83.1％)患者发生3～4级化疗不良反应,主要为骨髓抑制(73例,82.0％),未发生治疗相关死亡,女性患者3～4级化疗不良反应的发生率比男性高,分别为94.2％(33/35)、75.9％(41/54)(P=0.024).曾接受3次及以上化疗者较接受2次及以下化疗者易出现3～4级骨髓抑制,发生率分别为95.9％(47/49)、75.0％(30/40)(P=0.004),曾接受放疗的患者较未接受放疗者3～4级骨髓抑制风险高,发生率分别为100.0％(20/20)、78.2 ％(54/69)(P=0.022).结论 DA-BEACOP方案在淋巴瘤患者治疗中的不良反应具有可控性.

Toxicity of dose-adjusted BEACOP regimen in the treatment of lymphoma

Objective To analyze the toxicity of dose adjusted-BEACOP (DA-BEACOP,classic CHOP regimen plus etoposide and (or) bleomycin with or without rituximab) regimen for poor-prognosis lymphoma.Methods 89 patients with poor-prognosis lymphoma who had been treated in-patient at Peking University Third Hospital during August 2002 and February 2012 were retrospectively studied.All patients received at least 1 cycle of DA-BEACOP regimen.Results 3-4 grade adverse events were observed in 74 (83.1％) patients,most of which was myelosuppression (73 cases,82.0 ％).There was not death related with the treatment.Compared to male patients,female patients suffered higher rates of grade 3-4 of toxicity (94.2 ％,33/35 vs 75.9 ％,41/54) (P =0.024).The rate of grade 3-4 of hematological toxicity in patients who were pretreated with ≥3 cycles of chemotherapy than that in patients receiving≤2 cycles of chemotherapy (95.9 ％,47/49 vs 75.0 ％,30/40) (P =0.004),while the rate of 3-4 hematological toxicity in pret-radiotherapy posed patients was higher than that in their counterparts who did not receive radiotherapy (95.9 ％,47/49 vs 75.0 ％,30/40) (P =0.022).Conclusion The DA-BEACOP regimen showed manageable toxicity in patients with poor-prognosis lymphoma.