CEOP方案联合大剂量甲氨喋呤治疗有中枢复发倾向的侵袭性淋巴瘤

CEOP Regimen plus High-dose Methotrexate in the Treatment of Aggressive Lymphoma with Central Nervous System Recurrence Risk

目的探讨CEOP方案联合大剂量甲氨喋呤治疗有中枢复发倾向的侵袭性淋巴瘤的临床疗效。方法7例有中枢复发倾向的侵袭性淋巴瘤均接受CEOP方案联合大剂量甲氨喋呤(3.0 g·m-2,静脉滴注6h,第10天)化疗。结果 7例患者中,6例可评价疗效,均达到完全缓解。主要毒副反应为骨髓抑制(其中Ⅲ、Ⅳ度粒细胞减少发生率为41%)和谷丙转氨酶升高(44%),非血液学毒性少而轻,6疗程因粒细胞减少甲氨蝶呤给药延迟至第15天,无治疗相关性死亡发生。结论 CEOP方案联合大剂量甲氨喋呤治疗侵袭性淋巴瘤近期疗效较好,可作为有中枢复发倾向的侵袭性淋巴瘤的治疗方案,治疗过程中应当注意骨髓抑制和谷丙转氨酶升高的防治。

Objective To evaluate the clinical efficacy of CEOP regimen plus high-dose methotrexate in the treatment of aggressive lymphoma with central nervous system recurrence risk. Methods Seven cases of aggressive lymphoma with central nervous system recurrence risk were involved in this study,and received CEOP regimen plus high-dose methotrexate（3. 0 g·m^-2 ,continuous intravenous for 6 hours on the tenth day）chemotherapy. Results Of the 7 cases,6 cases were measurable and all achieved complete remission. The major toxicities were bone marrow suppression and transaminase elevation,the incidence of gradeⅢ-Ⅳ granulocytopenia was 41%,and the incidence of transaminase elevation was 44%,the non-hematologic toxicities was mild,high-dose methotrexate was delayed in the six cycles due to granulocytopenia,no treatment-related mortality was observed. Conclusion CEOP regimen plus high-dose methotrexate is effective in the treatment of aggressive lymphoma with central nervous system recurrence risk,the bone marrow suppression and transaminase elevation prevention and control should be applied.