雷利度胺联合利妥昔单抗治疗复发性滤泡性淋巴瘤的疗效

Efficacy analysis of lenalidomide combined with rituximab in recurrent follicular lymphoma

目的评估雷利度胺联合利妥昔单抗治疗滤泡性淋巴瘤的有效性和安全性。方法回顾性分析23例复发性滤泡性淋巴瘤患者并随访至2016年4月。根据是否联合使用利妥昔单抗分为两组。单纯治疗组:雷利度胺15 mg/d,第1~21天,然后停药7 d;第2个周期剂量加到20 mg,一共12个周期。联合治疗组:雷利度胺治疗基础上+利妥昔单抗每周375 mg/m2,持续4周。评估两组的不良反应及生存期,并运用统计学软件进行对比分析。结果单纯治疗组10例,联合治疗组13例。单纯治疗组有8例(80%),联合治疗组有10例(76.9%)患者完成了12个周期的治疗。两组临床缓解率比较差异无统计学意义(70%vs.84.6%,P=0.401)。不良反应中性粒细胞减少症(80%vs.76.9%,P=0.704)、疲劳(40%vs.46.2%,P=0.768)两组间差异无统计学意义,血栓形成(60%和15.4%,P=0.026)两组差异有统计学意义。平均随访3年发现,单纯治疗组的平均进展时间为(2.1±0.15)年,联合治疗组为(3.5±0.21)年两组差异有统计学意义(P<0.001)。单纯治疗组生存期为(3.2±0.46)年,联合治疗组生存期为(4.7±0.32)年,两组差异无统计学意义(P=0.36)。结论雷利度胺联合利妥昔单抗治疗复发性滤泡性淋巴瘤患者是安全有效的,较单独使用雷利度胺更能延长患者生存期,控制疾病进展。

Objective To evaluate the efficacy and safety of lenalidomide combined with rituximab in recurrent follicular lymphoma. Methods A randomized controlled trial on 23 patients with recurrent follicular lymphoma were con- ducted, with follow -up until April 2016. The participants were divided into two groups, simple treatment group （lenalid- omide 15mg/d alone） and combination group （lenalidomide 15 mg/d plus rituximab 375 mg/m2/week）. Results Ten cases were assigned into Simple treatment group, and 13 into combined treatment group. Amogn them, 8 （80%） cases in simple treatment group and 10 （76. 9% ） cases in combined treatment group completed 12 cycles of treatment. There was no significant difference of clinical remission between the two groups （70% vs. 84. 6% , P = 0. 401 ）. Adverse reactions included neutropenia （80% vs. 76. 9%, P = 0. 704）, fatigue （40% vs. 46. 2%, P = 0. 768）, thrombosis （60% vs. 15.4%, P =0. 026）. An average follow- up of 3 years showed that in simple treatment group the time of progress was （2.1 ±0. 15 ） years, which was （3.5 ± 0. 21 ） years in combined treatment group （ P 〈 0. 001 ）. The survival in simple treatment group was （3.2 ±0.46） years, which was （4. 7 ±0. 32） years in combined treatment group （P =0. 36）. Con- clusion The combination of lenalidomide with rituximab in treatment of recurrent follicular lymphoma is more effective and safer, providing prolonged survival and slow disease progression than lenalidomide alone.