【作者】 王华庆； 邱立华； 钱正子； 李维； 孟祥睿； 侯芸； 宋拯； 赵静； 崔秀珍； 郝希山；

【Author】 WANG Hua-qing,QIU Li-hua,QIAN Zheng-zi,LI Wei,MENG Xiang-rui,HOU Yun,SONG Zheng,ZHAO Jing,CUI Xiu-zhen,HAO Xi-shan Department of Lymphoma,Tianjin Medical University Cancer Hospital,Tianjin Key Laboratory of Cancer Prevention and Therapy,Tianjin 300060,China

【机构】 天津医科大学附属肿瘤医院淋巴肿瘤科天津市肿瘤防治重点实验室；

【摘要】 目的探讨FT(氟达拉滨及吡柔比星)方案作为二线解救方案治疗复发难治性的惰性淋巴瘤(Non-Hodgkin’s Lymphoma,NHL)的有效性和安全性。方法经组织病理学证实的复发难治性惰性NHL40例,采用FT方案化疗(氟达拉滨25mg/m~2/d,d1～d3;吡柔比星(THP)40mg/m~2/d,d1),28天为1周期,共6个周期。采用文献资料提供的FND(氟达拉滨,米托蒽醌及地塞米松)方案(氟达拉滨25mg/m~2/d,d1～d3;米托蒽醌10 mg/m~2/d,d1;地塞米松20mg/d,d1～d5,28天为1周期,共6个周期)治疗惰性NHL的数据为历史对照。结果FT组40例共治疗228个周期,总有效(CR+PR)25例,有效率62.5%,临床受益(CR+PR+SD)32例,受益率80%,中位无进展生存期超过20个月,2年总生存率70%;不良反应以中性粒细胞减少(32/40)(80.0%)最为常见[其中WHO分级Ⅰ～Ⅱ级(27/40)67.5%,Ⅲ～Ⅳ级(5/40)12.5%]经升血治疗处理恢复,均可耐受。FND组40例,总有效19例,有效率47.5%,中位无进展生存期22个月,2年总生存率58%;最常见的不良反应为中性粒细胞缺乏(WHO分级Ⅲ～Ⅳ级29%)和肺炎(23%)。FT组的疗效优于FND组,但两组间差异无统计学意义(P>0.05)。中位无进展生存期和2年总生存率两组间亦无统计学意义(P>0.05)。两组间的不良反应均为骨髓抑制,但FT组Ⅲ～Ⅳ级中性粒细胞缺乏较FND组为轻(P<0.05),肺炎发生率亦明显低于FND组(P<0.05)。结论FT方案治疗复发难治性惰性NHL的疗效肯定,骨髓毒性较FND方案为轻,肺炎发生率亦明显低于FND组,是复发难治性惰性NHL患者安全有效的解救方案。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of FT(Fludarabine and Pirarubicin) regimen in the treatment of refractory or relapsed indolent non-Hodgkin’s lymphoma(NHL). Methods A total of 40 patients with histopathologically proved relapsed or refractory indolent NHL were treated with FT regimen(Fludarabine 25mg/m~2×3,d1~d3;Pirarubicin 40mg/ m~2,d1), one cycle for 28days,total 6 cycles.The data of 95 indolent NHL patients(among them 40 cases were relapsed or refractory) from Hongkong treated with FND(Fludarabine,Noventrone and Dexamethasone) regimen(Fludarabine 25mg/m2~×3,d1～d3;Noventrone 10mg/ m~2,d1; Dexamethasone 20mg/d,d1~d5) were as history control.Results 40 patients were given 228 cycles chemotheerapy,overall response rate was 62.5%(25/40),the clinical response rate was 80% (32/40).Median progression-freely survival was more than 20 months and 2 years overall survival rate was 70%.The main toxicities was leucopenia(80.0%,WHOⅠ～Ⅱ°67.5%,Ⅲ～Ⅳ°12.5%).In the control group,40 relapsed or refractory patients were given FND regimen chemotherapy,overall response rate was 47.5%(19/40),median progression-freely survival was;22 months and 2 years overall survival rate was 58%.The main toxicities was leucopenia(WHOⅢ～Ⅳ°29%) and pneumonia(23%).There was better efficacy in overall response rate and 2 years overall survival rate between FT group and FND group(62.5%vs 47.5%,70%vs 58%),but the differences have no statistical significance(P>0.05).Leucopenia was the main toxicities in both groups,but WHOⅢ～Ⅳ°leucopenia and pneumonia in FT group was significant slighter than in the FND group(P<0.05).Conclusions The efficacy of FT regimen was as good as FND regimen,but WHOⅢ～Ⅳ°leucopenia and pneumonia was less in FT group than in FND group.So the FT regimen was a effective second-line salvage regimen for the treatment of relapsed or refractory indolent non-Hodgkin’s lymphoma.更多还原