氟达拉滨联合方案治疗复发难治非霍奇金淋巴瘤临床疗效观察

Clinical Observation of Fludarabine-based Chemotherapy for Relapsed or Refractory Non-Hodgkin Lymphoma Patients

目的观察氟达拉滨联合化疗治疗复发难治非霍奇金淋巴瘤临床疗效及安全性。方法 38例复发难治非霍奇金淋巴瘤患者均采用FND方案:氟达拉滨30mg/m2d1～3,米托蒽醌10mg/m2d1,曲安西龙80mgpod1～5,28天一周期。结果全组患者CR8例(21%),PR13例(34%),有效率56%;其中20例复发难治惰性淋巴瘤患者CR7例(35%),PR9例(45%),有效率80%;18例复发难治侵袭性淋巴瘤患者CR1例(6%),PR4例(22%),有效率28%(χ2=10.45,P=0.001)。全组患者中位随访22(1～47)月,复发难治惰性淋巴瘤患者中位生存期45(2～47)月,中位无进展生存期18(2～34)月;复发难治侵袭性淋巴瘤患者中位生存期15(2～45)月,中位无进展生存期3(1～22)月。不良反应主要为骨髓抑制和肺感染。结论氟达拉滨联合方案治疗惰性淋巴瘤疗效肯定,对复发难治侵袭性淋巴瘤患者疗效尚可,不失为一种治疗选择。

Objective To determine the efficacy and the safety of fludarabine-based chemotherapy for relapsed or refractory non-Hodgkin lymphoma patients.Methods Thirty-eight patients with relapsed or refractory non-Hodgkin lymphoma received FND regimen（fludarabine 30 mg/m2 iv.d1~3,mitoxantrone 10 mg/m2 iv.d1,triamcinolone 80 mg PO d1~5,every 28 days）.Results The overall response rates of all patients were 56%,CR 21% and PR 34%,respectively.Twenty patients were indolent lymphoma.Seven patients achieved CR and 9 patients achieved PR.The overall response rate was 80%.Eighteen patients were aggressive lymphoma.One patient achieved CR and 4 patients achieved PR.The overall response rate was 28%（P0.05）.The median PFS and OS of indolent lymphoma was 18（2~34）and 45 months,respectively.The median PFS and OS of aggressive lymphoma was 3（1~22）and 15 months,respectively.Myelosuppression and infection were the most common toxicities.Conclusion Fludarabine-based regimen is effective for indolent lymphoma patients and added an option for aggressive lymphoma patients.And drug-related toxicities are tolerable.