恩度联合CHOPT方案治疗AITL的初步疗效观察

Endostar in combination with CHOPT regimen for AITL

目的探讨重组人血管内皮抑制素（恩度）联合CHOPT方案治疗血管免疫母细胞性T细胞淋巴瘤（angioimmunoblastic T-cell lymphoma,AITL）的疗效及安全性。方法 14例初治AITL患者,均采用恩度联合CHOPT方案（CHOP方案＋替尼泊苷100 mg,iv.d1-3）治疗,恩度15 mg,iv.d1-14,21天为1周期,共4个周期。结果14例患者治疗后,CR 7例（50.0%）,PR 4例（28.6%）,客观缓解率为78.6%;中位PFS为16月,1年PFS为70.7%。不良反应主要为骨髓抑制,表现为白细胞减少,Ⅲ~Ⅳ度发生率为35.7%（5/14）。5例患者出现心电图ST-T段轻度改变,无胸闷、心悸、血压升高等不良反应。1例出现全身皮肤斑丘疹。无治疗相关性死亡。结论恩度联合CHOPT方案治疗初治AITL安全、有效,应进一步扩大病例数,开展前瞻性多中心临床试验。

Objective To investigate the efficacy and safety of recombinant human endostatin（ endostar） plus CHOPT regimen in patients with angioimmunoblastic T-cell lymphoma（ AITL）. Methods Fourteen patients with newly diagnosed AITL were treated with endostar plus CHOPT. Conditioning regimen consisted of classical CHOP plus teniposide100 mg,iv. d1- 3 and endostar 15 mg,iv. d1- 14 in a 3-week interval,4 cycles in total. Results Complete response（ CR） and partial response（ PR） rates were 50. 0%（ 7 /14） and 28. 6%（ 4 /14）,respectively,with an overall response rate（ ORR） of 78. 6%. The median progression-free survival（ PFS） and one-year PFS rate were 16 months and 70. 7%,respectively. Major toxicity was myelosuppression,which occurred with grade Ⅲ ~ Ⅳ leukopenia in 5 patients（ 35. 7%）.The occurrence of ST-T mild change was observed in 5 patients,with no cardiovascular symptoms such as palpitation,chest tightness and hypertension. One patient developed endostar-related systemic skin rash. There was no treatment-related death. Conclusion The preliminary study showed that endostar in combination with CHOPT regimen had encouraging efficacy with an acceptable toxicity profile in patients with newly diagnosed AITL.