威猛联合方案治疗中高度恶性及难治非何杰金恶性淋巴瘤的观察

Observation on Effectiveness of Teniposide(VM 26) Combination Chemotherapy Treating Intermediate or HighGrade and Refractory Patients with Malignant NonHodgkin Lymphoma(NHL)

目的为探讨威猛联合方案对中、高度恶性及难治复发非何杰金淋巴瘤（ＮＨＬ）的治疗效果。方法应用ＣＨＶＰ方案（环磷酰胺、阿霉素、威猛及强的松）或ＣＯＶＰＰ（环磷酰胺、长春新硷、强的松、威猛及顺铂）方案治疗４２例中、高度恶性及难治复发ＮＨＬ，其中Ⅲ期１２例，Ⅳ期３０例，２６例为初治恶性程度较高的病人，１６例为难治复发病例。结果完全缓解（ＣＲ）１８例（４２．９％），部分缓解（ＰＲ）１５例（３５．７％），总有效率为７８．６％，其中２６例初治病例中ＣＲ１２例（４６．２％），ＰＲ９例（３４．６％），１６例难治复发病例中ＣＲ６例（３７．５％），ＰＲ６例（３７．５％）。主要毒性反应为骨髓抑制，但经间歇期及ＧＣＳＦ治疗后均能恢复。结论这两方案是治疗中、高度恶性及难治复发ＮＨＬ的较有效而安全选择。

Objective To evaluate the effectiveness of Teniposide(VM 26) combination chemotherapy in the treatment of intermediate or highgrade and refractory malignant nonHodgkin lymphoma(NHL). MethodCombination chemotherapy of CHVP(cyclophosphamide,Adriamycin,teniposide and prednisone) and COVPP(cyclophosphamide,vincrisul,prednisone,teniposide and cisplatin) were used to treat 42 patients with intermediate or highgrade and refractory malignant NHL.Among 42 cases,12 cases were Ann Arbor stage and 30 cases were Ann Arbor stage .26 cases were previously untreated NHL,16 cases were refractory and relapsed NHL. Results 18 cases(42.9%) achieved complete remission(CR),15 cases(35.7%) achieved partly remission(PR).The total remission rate was 78. 6%(33/42).In 26 untreated cases,the CR rate was 46.2%(12/26),the PR rate was 34.6%(9/26).In 16 refractory and relapsed cases,they were 37.5%(6/16) and 37.5(6/16) respectively.The main toxicity was myelosuppression which could recover after the interval periods of chemotherapy and with/without the treatment of GCSF. Conclusions The two kinds of chemotherapy are efficacious and safe remedy for the treatment of intermediate or highgrade and refractory NHL.