美罗华联合ICE方案治疗复发非霍奇金淋巴瘤疗效观察

Observation of patients with recurrent non-Hodgkin lymphoma treated with rituximab in combination of CHOP regimen

目的观察和评价美罗华联合ICE方案治疗复发非霍奇金淋巴瘤（NHL）疗效及不良反应。方法20例复发性NHL患者采用美罗华联合ICE方案化疗。美罗华375 mg/m2，静脉滴注，第1天；异环磷酰胺1.5 g/m静脉滴注，第2～4天；卡铂200 mg/m避光静脉滴注，第2～4天；依托泊苷, 100 mg/m静脉滴注，第2～4天。21～28 d为1个周期，每例患者至少完成2个周期以上治疗后评价临床疗效及不良反应发生情况。结果20例患者中，完全缓解6例，部分缓解7例，无变化3例，进展4例，临床总有效率为65.0%。主要不良反应为骨髓抑制，主要表现为白细胞减少和血小板减少，其次为恶心呕吐，心脏、肝脏、肾脏、神经毒性和皮肤黏膜炎较少见。随访至2012年8月，中位生存期14个月。结论美罗华联合ICE方案可作为复发性中高度恶性NHL的治疗方案。

Objective To explore and observe the clinical effect and side effect of patients with recurrent non-Hodgkin lymphoma （NHL） treated by rituximab in combination of CHOP regi- men. Methods Twenty patients with recurrent non-Hodgkin lymphoma were treated with rituximab in combination of CHOP regimen （Rituximab 375 mg/m2, intravenous drip, dl; isosfamide 1.5 g/m2, intravenous drip, d2-4, 21-28 d in one cycle）. The clinical effect and side effect of pa- tients who received at least 2 cycles were evaluated . Results In 20 cases, CR in 6 cases （30.0 % ）, PR in 7 cases （35.0 % ）, NC in 3 cases （15.0 % ）, and PD in 4 cases （20.0 % ）. The total clinical effectiveness rate was 65.0 % （13/20）. Major side effect was bone marrow suppression, main expression included neutropenia and thrombocytopenia, and less expression included nausea and vomit- ing, toxicity in heart, liver, kidney, nerve and mucosa inflammation. Follow-up was conduted until August, 2012 with a medium survival time of 14 months. Conclusion Rituximab in combination of CHOP regimen can be used as clinical therapy of recurrent non-Hodgkin lymphoma.