利妥昔单抗联合化疗治疗弥漫型大B细胞淋巴瘤患者的临床研究

Clinical Studies of Rituximab Combined with Chemotherapy in the Treatment of Patients with Diffuse Large B Cell Lymphoma

目的:探讨利妥昔单抗与化疗相结合治疗弥漫型大B细胞淋巴瘤(diffuse large Bcelllymphoma,DLBCL)患者的可行性。方法:选取2002年1月至2011年5月我院收治的84例CD20阳性的DLBCL患者,采用利利妥昔单抗与化疗相结合的方法治疗,对其疗效及安全性进行评价,并对其影响因素进行分析。结果:有56例患者治疗艹6个周期,占66.67%;有28例患者治疗<6个周期,占33.33%。84例患者治疗的总有效率为83.33%。其中,初治组的总有效率为91.67%,明显高于复治组的62.5%,差异有统计学意义(P<0.05)。红细胞沉降率、国际预后指数评分、是否为初治、是否存在B症状以及利妥昔单抗的治疗周期等变量成为影响治疗效果的独立危险因素(P<0.05)。随访5年,治疗后第l年、2年、3年和5年患者的生存率分别为88.1%(74/84)、72.62%(61/84)、60.71%(51/84)、60.71%(51/84)。国际预后指数评分、利妥昔单抗的治疗周期以及治疗效果等变量是影响患者生存的独立危险因素(P<0.05)。结论:对于弥漫型大B细胞淋巴瘤患者尤其是对初治患者而言,利妥昔单抗联合化疗治疗具有更好的治疗效果,临床应用时不会加重患者的不良反应。

Objective： To investigate the efficacy and safety of rituximab combined with chemotherapy in the treatment of patients with diffuse large B cell lymphoma（DLBCL）. Methods： 84 cases of CD20-positive DLBCL patients were selected from January2002 to May 2011 in our hospital and were treated with rituximab combined with chemotherapy. The efficacy and safety and the influencing factors were evaluated and analyzed. Results： 56 patients were treated with rituximab therapy for more than 6 cycles,accounting for 66.67%; 28 patients were treated for less than 6 cycles, accounting for 33.33%. The total effective rate for the 84 cases of patients treated was 83.33%. Among them, the total effective rate of initial treatment group was 91.67%, which was significantly higher than that of the retreatment group（62.5%）, the difference was statistically significant（P〈0.05）. Erythrocyte sedimentation rate,international prognostic index score, whether the initial treatment, whether presence of B symptoms and rituximab treatment cycle variables were independent risk factors impact on the therapeutic effect（P〈0.05）. Follow-up of 5 years after treatment, the survival rates for 1 year, 2 years, 3 years and 5 years after treatment were 88.1%（74/84）,72.62%（61/84）,60.71%（51/84）, and 60.71%（51/84）.International prognostic index score, rituximab treatment cycles, and treatment variables were independent risk factors for survival（P〈0.05）.Conclusions： For patients with diffuse large B cell lymphoma, especially for newly diagnosed patients, rituximab combined with chemotherapy presents a better therapeutic effect, without increasing adverse reactions in patients in clinical applications.