沙利度胺联合R-GEMOX方案挽救治疗复发难治B细胞性非霍奇金淋巴瘤

Efficacy of thalidomide combined with R-GEMOX regimen in the treatment of relapsed/refractor B-cell non-hodgkin's lymphoma

目的观察沙利度胺联合R-GEMOX方案(利妥昔单抗联合吉西他滨、奥沙利铂)挽救性治疗复发、难治B细胞性非霍奇金淋巴瘤(NHL)的疗效和毒副反应。方法回顾性分析36例经正规标准方案治疗复发或难治的B细胞性NHL患者,采用沙利度胺(口服,100 mg/d起始,每周递增50 mg,直至200 mg/d,QN,维持)联合R-GEMOX方案(利妥昔单抗375 mg/m^2,第0天;吉西他滨1000 mg/m^2,第1、8天;奥沙利铂130 mg/m^2,第1天),21～28 d为一个周期,每2个疗程后评价疗效,每1个疗程评价毒副反应。结果 36例患者中,14例完全缓解(CR),15例部分缓解(PR),总有效率(CR+PR)为80%。15例具有B类症状的患者,13例症状消失,1例明显改善。毒副反应可耐受。结论沙利度胺联合R-GEMOX方案对复发难治B细胞性NHL疗效较好,毒副反应小,是一个良好的补救性化疗方案。

Objective To investigate the efficacy and toxicities of thalidomide(oral,starting dose 100 mg/d,increase 50 mg per week,up to 200 mg/d,QN,maintain)combined with R-GEMOX regimen (rituximab 375 mg/m^2 d0,gemcitabine 1000 mg/m^2,d1,d8,oxaliplatin 130 mg/m^2 d1)in treatment of relapsed/refractor B-cell Non-Hodgkin′s lymphoma(NHL). Methods Thirty-six patients with relapsed or refractor B-cell NHL after medication of traditional chemotherapy accepted thalidomide combined with R-GEMOX regimen,the efficacy toxicities was evaluated after two cycles of chemotherapy,the toxicities was evaluated after 1 cycles of chemotherapy. Results Of the 36 cases,14 patients were in complete remission and 15 in partial remission,resulting in an overall response rate of 80%. Thirteen patients symptom disappeared,and one in 15 cases was alleviated of type B symptoms. The toxicities can be tolerated. Conclusion Thalidomide combined with R-GEMOX regimen was effect for recurrent or refractory B-cell NHL,and the toxicity was mild. This protocol was worthy of clinical application as salvage for relapsed or refractory B-cell NHL.