R-DA-EPOCH方案治疗复发难治性弥漫性大B细胞淋巴瘤的疗效观察

Observation on efficacy of R-DA-EPOCH regimen in the treatment of relapsed and refractory diffuse large B-cell lymphoma

目的评价利妥昔单抗联合调整剂量的EPOCH(R-DA-EPOCH)方案治疗复发难治性弥漫性大B细胞淋巴瘤(DLBCL)的疗效及安全性。方法36例复发难治性弥漫性大B细胞淋巴瘤患者,采用R-DA-EPOCH方案治疗,观察其临床疗效和不良反应发生情况。结果治疗后,36例患者完全缓解(CR)8例(22.2%),部分缓解(PR)12例(33.3%),稳定(SD)6例(16.7%),疾病进展(PD)10例(27.8%),总缓解率(RR)为55.6%。36例患者的不良反应主要包括白细胞减少、血小板减少、贫血、心脏毒性、脱发,发生率分别为100.0%(36/36)、80.6%(29/36)、86.1%(31/36)、19.4%(7/36)、100.0%(36/36)。36例患者的中位生存期为12.4个月。结论采用R-DA-EPOCH方案治疗复发难治性弥漫性大B细胞淋巴瘤具有较好疗效,不良反应可控,有助于提高总生存期。

Objective To evaluate the efficacy and safety of rituximab combined dose-adjusted EPOCH (R-DA-EPOCH) regimen in the treatment of relapsed and refractory diffuse large B-cell lymphoma (DLBCL). Methods A total of 36 patients with relapsed and refractory diffuse large B-cell lymphoma all received R-DA-EPOCH regimen for treatment,and their clinical efficacy and occurrence of adverse reactions were observed.Results After treatment,there were 8 complete remission (CR) cases (22.2%),12 partial remission (PR) cases (33.3%),6 stable disease (SD) cases (16.7%) and 10 progression of disease (PD) cases (27.8%),with total remission rate (RR) as 55.6% in 36 cases.The main adverse reactions in 36 patients were leukopenia, thrombocytopenia,anemia,cardiotoxicity,alopecia,and the incidence rates were 100.0%(36/36),80.6%(29/36), 86.1%(31/36),19.4%(7/36) and 100.0%(36/36),respectively.The median survival time of 36 patients was 12.4 months.Conclusion R-DA-EPOCH regimen shows good efficacy in treating relapsed and refractory diffuse large B-cell lymphoma with controllable adverse reactions, which is helpful to improve the overall survival time.