沙利度胺联合ICE方案治疗复发性难治性非霍奇金淋巴瘤

Effect of thalidomide combined with ICE regimen in the treatment of relapsed and refractory non-Hodgkin's lymphoma

目的:探讨沙利度胺联合ICE(异环磷酰胺、卡铂和依托铂苷)方案治疗复发性或难治性非霍奇金淋巴瘤(NHL)的疗效及不良反应。方法:25例经传统化疗方案化疗后复发或难治性NHL患者采用沙利度胺联合ICE方案化疗。化疗至少2个周期后评价疗效及不良反应。结果:25例患者中,完全缓解7例,部分缓解9例,无变化4例,进展5例,总有效率为64.0%。治疗后,血清LDH水平低于治疗前,差异有统计学意义(P<0.05)。主要不良反应为骨髓抑制,其中Ⅲ-Ⅳ度血小板减少10例,Ⅲ-Ⅳ度白细胞减少9例,Ⅲ-Ⅳ度血红蛋白减少7例,经对症治疗后未影响化疗的顺利进行。其他不良反应均属Ⅰ-Ⅱ度。结论:沙利度胺联合ICE方案治疗复发或难治性NHL疗效较好,不良反应可以耐受。

Objective：To investigate the efficacy and adverse reactions of thalidomide combined with ICE regimen （ifosfamide ,earboplatin and etoposide） in the treatment of relapsed or refractory non- Hodgkin＇s lymphoma（NHL）. Methods：All 25 patients with relapsed or refractory NHL after medication of traditional chemotherapy accepted tha- lidomide combined with ICE regimen. The efficacy and adverse reactions were evaluated after at least 2 cycles of chemotherapy. Results：Of the 25 cases, complete remission （CR） was observed in 7 cases, partial response （PR） in 9 cases, stable disease （SD） in 4 cases, and progressive disease （PD） in 5 cases, the total effective rate was 64%. After the treatment ,serum LDH levels was significantly lower than that before treatment（ P 〈0.05 ）. The main adverse re- actions were myelosuppression,including 10 cases of degree Ⅲ -IV thrombocytopenia,9 cases of degree Ⅲ- IV leu- copenia, and 7 cases of degree Ⅲ - IV reduced hemoglobin. After symptomatic treatment,they didn＇t affect the smooth progress of chemotherapy. The other adverse reactions belonged to degree I - Ⅱ. Conclusion ： Thalidomide combined with ICE regimen is effective for relapsed and refractory NHL,adverse reactions can be tolerated.