利妥昔单抗联合CEOP方案治疗侵袭性B细胞淋巴瘤的近期疗效

Short-term efficacy of combination of MabThera and CEOP regimen in the treatment of aggressive B-cell lymphoma

目的 :研究利妥昔单抗 (美罗华 )联合CEOP方案治疗侵袭性B细胞淋巴瘤的疗效及其不良反应。方法 :2 1例侵袭性B细胞淋巴瘤 ,中数年龄 4 8岁 (15～ 6 8岁 ) ,使用利妥昔单抗联合CEOP方案 ,利妥昔单抗 375mg/m2第 1天 ,环磷酰胺 75 0mg/m2 第 3天 ,表柔比星 6 0mg/m2 第 3天 ,长春新碱 2mg第 3天和强的松 4 0mg/m2 第 3～ 7天。结果 :完全缓解 16例 (76 .2 % ) ,部分缓解 3例 (14 .2 % ) ,稳定 1例 (4 .8% )和进展 1例 (4 .8% ) ,有效率为 90 .5 %。 19例有效患者随访 2～ 15月 ,1例甲状腺淋巴瘤完全缓解 14月后复发 ,其余患者均处于缓解中。 2 1例患者87个次治疗中仅观察到 1例利妥昔单抗输注相关反应 ,血液学毒性主要是白细胞减少和中性粒细胞减少 ,Ⅲ～Ⅳ度中性粒细胞减少 5例 (2 3.8% ) ,中性粒细胞减少性发热 1例。除脱发为Ⅲ度外 ,其他非血液学毒性均为Ⅰ～Ⅱ度。结论 :利妥昔单抗联合CEOP方案治疗侵袭性B细胞淋巴瘤疗效高而不良反应轻 ,有望成为标准治疗。

Purpose:To evaluate the efficacy and toxicity of combination of MabThera and CEOP regimen in the treatment of aggressive B-cell lymphoma. Methods:21 patients diagnosed as aggressive B-cell lymphoma with median age of 48 years old (from 15 to 68 years old),received the treatment of MabThera plus CEOP regimen. This treatment consisted of MabThera 375 mg/m2 intravenously infusion on day 1,cyclophosphamide 750 mg/m 2 ,epirubicin 60 mg/m 2 ,vincristine 2 mg on day3 ,prednisone 40 mg/m 2 orally taken on day 3～7. Results:In all 21 patients,16 (76.2%) complete response and 3 (14.2%) partial response were observed. Thus,the overall response rate was 90.5%. Moreover,of the remaining patients,1(4.8%) achieved stable disease and 1(4.8%) had progressive disease. In the 19 responsive patients,the follow-up duration were from 2 to 15 months. One case of thyroid lymphoma experienced recurrence after 14 months with complete response. Until now,the other responses have been maintained. Only one dose of MabThera infusion related-toxicity was observed in all who received 87 cycles. The hematological toxicities were mainly leucopenia and neutropenia. 5( 23.8% ) experienced 3-4 grade neutropenia. Only 1 patient developed neutropenia fever. The other non-hematological toxicities were 1-2 grade except grade 3 alopecia. Conclusions:The combination of MabThera and CEOP regimen had high efficacy with mild toxicity in the treatment of aggressive B-cell lymphoma,hopefully may become the standard treatment.