【摘要】 目的:探讨利妥昔单抗(美罗华)联合化疗方案治疗CD20阳性B细胞非霍奇金淋巴瘤(B-NHL)本地区患者的疗效及安全性,尤其是乙肝病毒表面抗原(HBsAg)阳性者的安全性,并分析影响疗效的相关因素。方法:回顾总结美罗华联合化疗方案治疗67例B-NHL患者的疗效、不良反应,比较HBsAg阳性与阴性患者在肝功能受损上的差别,分析年龄、分期、B症状、乳酸脱氨酶(LDH)、IPI评分及巨块等因素对疗效的影响。结果:67例中完全缓解44例(65.7%),部分缓解17例(25.4%),无变化+进展6例(9%),总有效率91%;初治患者42例,总有效率(完全缓解+部分缓解)95.2%,完全缓解32例(76.2%),部分缓解8例(19%),无变化+进展2例(4.8%)。IPI评分(P=0.006)、分期(P=0.023)、血清LDH水平(P=0.016)对疗效均有明显影响;而B症状(P=0.593)、巨块(P=0.160)、年龄(P=0.442)对疗效无明显影响。主要不良反应为骨髓抑制及肝功能受损,Ⅰ、Ⅱ度骨髓抑制50.7%,Ⅲ、Ⅳ度骨髓抑制44.7%;HBsAg阴性者Ⅱ～Ⅳ度肝功能损害10.2%,HBsAg阳性者(抗病毒治疗)Ⅱ～Ⅳ度肝功能损害16.6%,HBsAg阳性者(未抗病毒治疗)Ⅱ～Ⅳ度肝功能损害50%。结论:美罗华联合化疗方案治疗本地区B-NHL同样疗效确切、安全;肿瘤期别、血清LDH水平及IPI评分对疗效有明显影响;对HBsAg阳性者需提前予抗乙肝病毒治疗,免疫化疗仍然安全、有效。更多还原

【Abstract】 Objective:To evaluate the efficacy and safety of rituximab combined with chemotherapy on CD20(+)B-cell non Hodgkin’s lymphoma(B-NHL)in patients of local area and the patients of HBsAg(+).Methods:Clinical data from 67 patients with B-NHL confirmed by pathological examination in Fujian Tumor Hospita1 were collected.All patients received rituximab and chemotherapy.The efficacy and adverse reaction were evaluated.Results:The complete remission(CR)rate was 65.7% (44/67)and partial response(PR)rate was 25.4% (17/67).The total response rate(CR+PR)was 91% (61/67);in 42 patients with previously untreated,CR(32/42)76.2%,PR(8/42)19%,CR+PR (40/42)95.2%.Serum level of LDH(P=0.016),stages(P=0.023),and IPI(P=0.006) had significant effects on therapeutic efficacy.But B symptoms(P=0.593),Bulky(P=0.160),and age(P=0.442) had no significant effects on clinical efficacy.The primary adverse reaction was marrow depression and hepatic injuries,Ⅰ or Ⅱdegree marrow depression was 50.7%,Ⅲ or Ⅳdegree marrow depression was 44.7%;Ⅱ-Ⅳdegree hepatic injuries was 10.2% in the HBsAg(-);Ⅱ-Ⅳdegree hepatic injuries was 16.6% in the HBsAg(+) of preemptive antivirus therapy;Ⅱ-Ⅳdegree hepatic injuries was 50% in the HBsAg(+) of without using preemptive antivirus therapy.Conclusion:Rituximab combined with chemotherapy is effective and safe for B-NHL in patients of local area,the patients of HBsAg(+) received preemptive antivirus therapy,It is same safe and effective.更多还原