改良Hyper-CVAD方案治疗恶性淋巴瘤患者的安全性和疗效评价

Efficacy of modified Hyper-CVAD regimen on non-Hodgkin's lymphoma and safety evaluation

背景与目的:常规化疗方案治疗某些病理类型的侵袭性淋巴瘤疗效不佳。本研究评价改良Hyper-CVAD方案治疗侵袭性淋巴瘤患者的安全性和疗效。方法:对2004年6月至2008年6月在中国医学科学院肿瘤医院接受改良Hyper-CVAD方案化疗的31例非霍奇金淋巴瘤患者的不良反应和疗效等资料进行分析和评价。结果:31例患者共完成91个周期A方案,41个周期B方案化疗。中位化疗周期为4周期(1～7周期)。患者主要的不良反应是骨髓抑制,接受A方案和B方案期间Ⅲ～Ⅳ度粒细胞减少、血小板减少和粒细胞减少性发热的发生率分别为49.5%和80.5%、3.3%和82.9%以及12.1%和46.3%。全组无治疗相关死亡。共26例患者可评价疗效,总的客观缓解率达80.8%,12例达到完全缓解(46.2%)。结论:改良Hyper-CVAD方案是治疗侵袭性和高度侵袭性非霍奇金淋巴瘤患者较有前景的方案。

Background and Objective. The efficacy of standard chemotherapy regimen on aggressive non-Hodgkin＇s lymphoma （NHL） of certain pathologic types is unsatisfied. This study was to evaluate the safety and efficacy of modified Hyper-CVAD regimen in Chinese patients with aggressive NHL. Methods. Clinical records of 31 NHL patients who received modified Hyper- CVAD regimen in Cancer Hospital of Chinese Academy of Medical Sciences from June 2004 to June 2008 were analyzed in terms of toxicity and response. Results： The 31 patients totally received 91 cycles of regimen A and 41 cycles of regimen B with a median of 4 cycles （ranged 1-7 cycles）. The major toxicity was myelosuppresion, the occurrence rates of neutropenia of grades III-IV, thrombocytopenia and febrile neutropenia were 49.5%, 3.3% and 12.1% during treatment of regimen A, and were 80.5%, 82.9% and 46.3% during treatment of regimen B. No treatment-related death was observed. The response was assessable in 26 patients. The total response rate was 80.8%, and 12 patients achieved complete response （46.2%）. Conclusion： Modified Hyper-CVAD regimen is a promising regimen for the patients with aggressive and highly aggressive NHL.