Brentuximab vedotin联合氮芥治疗六例复发难治性霍奇金淋巴瘤疗效分析

Effect of brentuximab vedotin combined with chlormethine hydrochloride on the treatment of 6 patients with relapsed and refractory Hodgkin lymphoma

目的 观察Brentuximab vedotin （BV）联合盐酸氮芥治疗复发难治性经典型霍奇金淋巴瘤（cHL）患者的疗效及不良反应.方法 对6例BV单药治疗失败后cHL患者给予BV联合盐酸氮芥治疗,具体用药：BV 1.2～1.8 mg/kg第1天静脉滴注,盐酸氮芥6 mg/m2第1天静脉滴注,每21d为1个疗程,中位疗程数为4（3～8）个.治疗后每2个疗程行CT检查,每4个疗程行PET-CT检查,每个疗程前行血常规和生化检查,评价临床疗效与不良反应.结果 6例患者中男4例,女2例,中位年龄20.5（17～26）岁;2例为BV治疗达完全缓解后复发,4例为BV治疗后病情稳定.中位观察时间为15（11～25）周.6例患者接受BV联合盐酸氮芥治疗后2例获得完全缓解,4例获得部分缓解,总有效率为100％.4例患者出现骨髓抑制（Ⅰ度2例,Ⅳ度2例）;2例出现Ⅱ度胃肠道反应;1例出现Ⅰ度肝损伤,心肌酶增高;1例出现Ⅰ度口腔溃疡.不良反应可耐受或对症处理后症状缓解,未影响患者治疗.结论 BV联合盐酸氮芥治疗BV单药治疗失败后复发难治性cHL,疗效显著,不良反应可耐受.

Objective To observe the clinical efficacy and side effects of brentuximab vedotin （BV） plus chlormethine hydrochloride （CH）in patients with relapsed and refractory Hodgkin lymphoma （HL）after failure with BV alone.Methods From March,2014 to December,2014,6 patients who failed with BV monotherapy were enrolled in this study.The chemotherapy regimen consisted of BV （1.2-1.8 mg/kg,iv.gtt,d1）and CH （6 mg/m2,iv.gtt,d1）was given for 3 weeks as one course,and all patients received about 3-8 courses of chemotherapy,with an median of 4 courses.Clinical efficacy and adverse events were assessed and observed by radiographic examination and serological detection.Results Among 6 patients,the overall response rate was 100% with 2 complete remissionand 4 partial remission.The main adverse events were grade Ⅰ （2 patients）and Ⅳ （2 patients）bone marrow depression,grade Ⅱ （2patients）gastrointestinal reaction,grade Ⅰ （1 patient）increase oftransaminase and myocardial enzymc and grade Ⅰ （1 patient）mouth ulcers.Conclusion The combination of BV and CH in the treatment of relapsed and refractory HL after failure with BV alone was high effective and the toxicities were well tolerable.