Hyper-CVAD方案治疗淋巴母细胞淋巴瘤

 目的　观察Hyper-CVAD方案对淋巴母细胞淋巴瘤（LBL）的疗效及其毒副作用。方法　2003年11月至2006年12月收治LBL患者40例，其中20例接受Hyper-CVAD／MA方案交替治疗8个疗程；另20例予常规急性淋巴细胞白血病方案，包括VDCLP、CAT、HD-MTX、EA等方案交替治疗，后予维持治疗。结果　Hyper-CVAD方案组：诱导化疗结束后CR18例（90 ％），PR2例（10 ％），总有效率100 ％，3年无病生存率（DFS）55 ％，总体生存率（OS）66 ％。常规急淋方案组：诱导化疗结束后CR17例（85 ％）PR1例（5 ％），PD2例（10 ％），总有效率90 ％，3年DFS 35 ％，OS 52 ％。两组患者在诱导期的CR率和有效率差异无统计学意义。3年DFS和3年OS的差异均有统计学意义（P＜0.05）。结论　Hyper-CVAD方案可以提高LBL患者的长期无病生存率，可作为LBL一线治疗方案之一。

Efficacy of hyper-CVAD regimen on patients with lymphoblastic lymphoma

Objective　The therapy of lymphoblastic lymphoma (LBL) has evolved with use of chemotherapy regimens modeled after those for acute lymphocytic leukemia (ALL). The study was designed to evaluate the efficacy of the intensive chemotherapy regimen hyper-CVAD. Methods　A total of 40 patients were enrolled. They were divided into two groups randomly. 20 patients were treated with the intensive chemotherapy regimen Hyper-CVAD (fractionated cyclophosphamide, vincristine, adriamycin, and dexametha－sone). Induction consolidation was administered with 8 alternating cycles of chemotherapy with intrathecal chemotherapy prophylaxis, followed by maintenance therapy. As a contrast, the other patients received the rou－tine regimen of all consisting of induction, consolidation and central nervous system prophylasis and mainte－nance therapy. Results　The patients in the Hyper-CVAD group, 18 (90 %) achieved complete remission, and 2 (10 %) achieved partial response. Within a median of 13 months, 9 patients (45 %) relapsed or pro－gressed. Estimates for 3-year progression-free and overall survival for the 33 patients were 55 % and 66 %, respectively. In the contrast, 17 (85 %) achieved complete remission, and 1 (5 %) achieved partial response. Estimates for 3-year progression-free and overall survival for the 33 patients were 35 % and 52 %, respec－tively. There was no statistic difference in CR and response rates in induction therapy but both DFS and OS at 3 years for Hyper-CVAD group were significantly better than those in the contrast group (P <0.05).　Con－clusion　The intensive chemotherapy regimens Hyper-CVAD significantly improve the survival rate of LBL patients and it was feasible for Chinese patients.