感染乙肝病毒的恶性淋巴瘤应用拉米夫定预防性治疗的临床观察

The clinical observation of preventive treatment of the patients with non-Hodgkin's lymphoma com-bined with HBV infection using lamivudine

目的探讨感染乙肝病毒的非霍奇金淋巴瘤患者化疗前预防应用拉米夫定在降低HBV再激活、减少肝功能损害方面的作用。方法 21例感染HBV的NHL接受CHO方案化疗4～6周期及预防应用拉米夫定抗病毒治疗(A组),69例NHL接受CHOP方案化疗4～6周期(B组)。结果 A组CR率为38.1%(8/21),B组CR率为42.0%(29/69)(P=0.2579);A组有19.0%(4/21)化疗后肝功能损害,B组有14.5%(10/69)化疗后肝功能损害(P=0.0725);A、B组均未发生HBV再激活。结论感染HBV的NHL应用CHO联合方案治疗及在化疗前预防抗病毒治疗能明显降低HBV再激活、减少肝功能损害。

Objective To study the efficacy of preventive use of lamivucine before chemotherapy in reducing HBV reactivation and liver function injury in patients with non-Hodgkin＇s lymphoma combined with HBV infection. Methods Twenty-one patients with NHL and HBV infection were treated with CHO regimen for four or six cycles and preventive use of lamivudine（ group A） ; Sixty-nine NHL patients were treated with CHOP regimen for four or six cycles（ group B） . Results The complete response rate of group A was 38. 1% , group B was 42. 0% （ P =0. 2579） . The liver function injury rate in group A was 19. 0% ,that in group B was 14. 5% （ P =0. 0725） . Hepatitis B reactivation did not occur in both groups. Conclusion Patients with nonHodgkin＇s lymphoma combined with HBV infection treated with CHO regimen and prevention with anti-viral treatment before the chemotherapy can reduce HBV reactivation and liver function injury obviously.