苯丁酸氮芥单药治疗复发难治性低度恶性非霍奇金淋巴瘤37例临床观察

 目的 探讨苯丁酸氮芥（chlorambucil）单药治疗复发难治性低度恶性非霍奇金淋巴瘤（NHL）的临床效果。方法 37例既往曾接受多种常规方案化疗的低度恶性NHL患者，在病情再次快速出现进展时，选用苯丁酸氮芥单药治疗。所有患者均经病理学诊断，其中B细胞来源27例，T细胞来源10例。使用过的化疗方案数为2 ~ 5种（包括CHOP，IMVP-16，DHAP，IVAC，MINE），累计中位疗程数为11个周期。苯丁酸氮芥单药治疗0.15 mg／kg，1次／d，持续口服3个月后，评价近期疗效，临床受益患者以2 mg／d口服维持治疗12个月。结果 应用苯丁酸氮芥治疗复发难治性低度恶性NHL的近期疗效达62.2 %，中位无病生存期（DFS）为11个月，毒副反应主要表现在可耐受的Ⅰ~Ⅱ度消化道反应和骨髓抑制反应。结论 苯丁酸氮芥单药口服维持治疗复发难治性低度恶性NHL有确切疗效，毒副反应可耐受，安全性好。

Clinical observation of single-agent chemotherapy with chlorambucil in 37 patients with chemotherapy-refractory indolent non-Hodgkin lymphoma

Objective To appraise the efficacy, survival time and toxicity of chlorambucil, as last qualifying chemotherapy, in retreatment of 37 chemotherapy-refractory indolent non-Hodgkin lymphoma patients. Methods 37 patients who had been treated with at least two protocol-specified qualifying chemotherapy regimens and had not responded or progressed within 6 months after their LQC were treated with a single course of chlorambucil 0.15 mg/kg, once daily, when pathogenetic condition had made advancement quickly. The efficacy and toxicity after three months were evaluated. The responding patients were randomly assigned to maintenance therapy with maintained 2 mg per day for 12 months. Results 37 eligible patients were enrolled onto the study. Median progression-free survival time was 11 months. Conclusion Chlorambucil is effective as second-line chemotherapy for chemotherapy-refractory indolent non-Hodgkin lymphoma patients.