利妥昔单抗联合CHOP与单用CHOP方案治疗初治弥漫大B细胞淋巴瘤疗效及安全性对比

陈艳欣; 郑晓云; 刘庭波; 郑静; 郑志宏; 胡建达

doi:10.13201/j.issn.1004-2806.2015.09.007

利妥昔单抗联合CHOP与单用CHOP方案治疗初治弥漫大B细胞淋巴瘤疗效及安全性对比

- 1 福建医科大学附属协和医院血液科, 福建省血液病研究所, 国家及福建省临床重点专科(福州, 350001)
基金项目:
卫生行业科研专项(No:201202017,重大血液病诊断规范化和治疗策略优化的研究)

详细信息

通讯作者: 胡建达,E-mail:jdhu@medmail.com.cn

中图分类号: R733.4

收稿日期: 2015-02-26

Comparison of the efficacy and safety of rituximab plus CHOP and CHOP alone regimens in patients with newly diagnosed diffuse large B-cell lymphoma

- Department of Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, State and Fujian Province Key Clinical Department, Fuzhou, 350001, China

More Information

Corresponding author: HU Jianda, E-mail: jdhu@medmail.com.cn

Received Date: 26 February 2015

摘要

摘要: 目的:探讨使用利妥昔单抗联合CHOP或单用CHOP方案化疗治疗初治弥漫大B细胞淋巴瘤(DLBCL)的疗效及安全性。方法:回顾性分析144例初治DLBCL患者的临床资料,分为利妥昔单抗联合化疗(R-CHOP组,99例)和单用化疗(CHOP组,45例),至少化疗4个疗程,中位随访25(2~74)个月,比较2组疗效及不良反应。结果:99例R-CHOP组中,66例(66.7%)达完全缓解(CR),23例(23.2%)达部分缓解(PR),1例(1.0%)疾病稳定(SD),9例(9.1%)疾病进展(PD),总有效率(ORR)为89.9%,3年总生存(OS)、无进展生存(PFS)率分别为82.1%和69.6%。45例CHOP组中,22例(48.9%)达CR,18例(40.0%)达PR,5例(11.1%)PD,ORR为88.9%,3年OS、PFS率分别为60.7%和57.9%。R-CHOP组较CHOP组CR率显著增高(P=0.043),OS和PFS显著延长(P值分别为0.041、0.046)。年龄≤60岁的R-CHOP组较CHOP组CR率及OS、PFS率显著提高(P值分别为0.014、0.004、0.007)。非生发中心型的R-CHOP组CR率较CHOP组显著增高(P=0.012)。生发中心型的R-CHOP组较CHOP组OS、PFS显著延长(P值分别为0.025、0.004)。不良反应主要为骨髓抑制和胃肠道反应,2组不良反应相似。结论:利妥昔单抗联合CHOP化疗较单用CHOP化疗可以明显提高初治DLBCL的缓解率并延长生存期,且安全性好。
- 淋巴瘤,大B细胞,弥漫性 /
- 利妥昔单抗 /
- 化疗 /
- 疗效
Abstract: Objective:To evaluate the efficacy and safety of rituximab plus CHOP and CHOP alone regimens in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL).Method:A total of 144 patients with newly diagnosed DLBCL were retrospectively studied.Ninety-nine cases were treated with rituximab plus chemotherapy (R-CHOP group) and 45 cases with chemotherapy alone (CHOP group) regimen for at least four cycles,with a median follow-up for 25 (2 to 74) months.The efficacy and adverse effects between two groups were compared.Result:Among 99 patients with rituximab plus CHOP chemotherapy,66 (66.7%) achieved complete remission (CR),23 (23.2%) achieved partial remission (PR),1 (1.0%) had stable disease (SD),9 (9.1%) had progressive disease (PD),with 89.9% overall response rates (ORR).Overall survival (OS) and progression free survival (PFS) at 3 years were 82.1% and 69.6%.Among 45 patients in CHOP group,22 (48.9%) achieved CR,18 (40.0%) achieved PR,5 (11.1%) had PD;ORR were 88.9%,OS and PFS at 3 years were 60.7% and 57.9%.Patients in R-CHOP group showed superior CR rates,OS and PFS (P=0.043,0.041,0.046,respectively).Patients at 60 years of age or younger treated with R-CHOP regimen displayed a significant better CR rates,OS and PFS (P=0.014,0.004,0.007,respectively) than CHOP therapy.After R-CHOP treatment,CR rates were improved for patients with non-GCB type (P=0.012) and OS,PFS were improved for patients with GCB type (P=0.025,0.004,respectively).Common adverse events were myelosuppression and gastrointestinal reaction.Adverse effects were similar between two groups.Conclusion:The treatment of rituximab plus CHOP lead to higher CR [HK]
- diffuse large B-cell lymphoma /
- rituximab /
- chemotherapy /
- efficacy

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