美罗华联合Hyper-CVAD/MTX+Ara-C方案治疗高危青年伯基特淋巴瘤的疗效观察(附6例)

Observation on the efficacy of rituximab combined with Hyper-CVAD/MTX+Ara-C regimen in the treatment of 6 cases of high-risk young Burkitt lymphoma

目的:分析美罗华联合Hyper-CVAD/MTX+Ara-C方案治疗高危青年伯基特淋巴瘤的治疗效果。方法:总结2014年10月至2016年10月,我院收治的6例伯基特淋巴瘤患者的特征,均采用美罗华联合Hyper-CVAD/MTX+Ara-C方案化疗,历时4个周期共8个疗程,病程中腰穿及鞘注。结果:6例初诊患者临床分期(Arbor分期)Ⅲ期1例,Ⅳ期5例;首发部位多见于腹部包块及浅表淋巴结,均有B症状,乳酸脱氢酶(LDH)水平偏高,骨髓侵犯3例,中枢神经系统侵犯1例,有结外侵犯者3例。总疗程结束后评估,CR 5例,PR 1例,平均缓解期2.3个月。随访2.5年,5例患者病情稳定,1例死亡。结论:美罗华联合Hyper-CVAD/MTX+Ara-C方案治疗高危青年伯基特淋巴瘤有一定效果,患者对联合化疗的耐受性尚可。

Objective:To analyse the therapeutic effect of rituximab combined with Hyper-CVAD/MTX+Ara-C regimen in the treatment of high-risk young Burkitt lymphoma.Methods:To summarize the characteristics of 6 patients with Burkitt lymphoma treated in hospital from October 2014 to October 2016,rituximab combined with Hyper-CVAD/MTX+Ara-C regimen was used in all patients,which total of 8 courses of treatment lasted 4 cycles.Lumbar puncture and sheath injection were used.Results:Clinical staging(Arbor staging)of 6 newly diagnosed patients:1 case in stageⅢand 5 cases in stageⅣ.The primary site was abdominal mass and superficial lymph nodes,all with B symptoms,high lactate dehydrogenase,bone marrow invasion in 3 cases,central nervous system invasion in 1 case,3 cases with extranodal invasion.There were 5 cases with CR and 1 case with PR,with an average median remission period of 2.3 months.Follow-up of 2.5 years showed that 5 patients were in stable condition and 1 was died.Conclusion:Rituximab combined with Hyper-CVAD/MTX+Ara-C regimen has a certain effect in the treatment of high-risk young Burkitt lymphoma,and the patient's tolerance to combined chemotherapy is acceptable.