MINE方案挽救治疗36例非霍奇金淋巴瘤

MINE regimen as salvage chemotherapy for 36 patients with non-Hodgkin's lymphoma

目的用MINE方案（美司钠/异环磷酰胺、米托蒽醌和依托泊甙）挽救治疗36例中、高度恶性非霍奇金淋巴瘤（NHL）,并观察其疗效和毒性反应。方法36例均为一线化疗失败和复发的NHL患者,用MINE挽救治疗,21天为一个周期,中位周期数4个（2-6个周期）。结果总有效率（RR）为47.2%,完全缓解率（CR）为22.2%,一线治疗失败患者的RR为36.8%,复发者为58.8%。Ⅰ-Ⅱ期和Ⅲ - Ⅳ 期患者的RR分别为71.4%和31.8%。中位缓解期9个月（4-21个月）,中位生存期11个月（3-25个月）,2年生存率为32.3%。该方案的主要毒性反应为骨髓抑制。结论MINE方案治疗中、高度恶性一线方案诱导治疗失败以及复发的NHL具有一定的疗效,毒副作用可以耐受。

Objective To observe the therapeutic effects and toxicity of MINE regimen as salvage chemotherapy in patients with non-Hodgkin＇s lymphoma. Methods Thirty-six patients with intermediate-grade and high-grade non-Hodgkin＇s lymphoma were treated by MINE regimen （mesna/ifosfamide,mitoxantrone and etoposide）,who either failed to respond the front-line chemotherapy regimen or relapsed. Treatment cycles were 21 days apart and patients received a median of 4 cycles （range 2- 6） of treatment. Results Overall, 47. 2% of the patients responded,with 22. 2% having a complete response （CR）. Patients with front-line chemotherapy failure had a 36.8% response rate （RR） and those with relapsed a 58.8% RR. There were 71.4% and 31.3% RRs in the patients of stage Ⅰ -Ⅱ and stage Ⅲ - Ⅳ ,respectively. Median remission time was 9 months （range 4-21）. Median survival time was 11 months （range 3-25） with a 2-year survival rate of 32.3%. The major toxicity was myelosuppression. Conclusions MINE regimen is effective for patients （intermediate-grade and high-grade） with induction failure and relapsed NHL. Its toxicity is well tolerated.