利妥昔单抗联合短周期、高强度方案治疗Burkitt白血病疗效及安全性分析

Rituximab combined with short-course and intensive regimen for Burkitt leukemia:efficacy and safety analysis

目的探讨利妥昔单抗联合短疗程、高强度方案治疗成人Burkitt白血病患者的疗效和安全性。方法收集2006年1月30日至2018年9月12日中国医学科学院血液病医院收治的11例Burkitt白血病患者病例资料,分析统计患者的临床特征、完全缓解(CR)率、总生存率、无复发生存率及不良事件。结果 11例患者中位年龄34(15~54)岁,其中男6例,女5例。发病时中位WBC 12.28(2.21~48.46)×10^9/L,HGB 113(74~147)g/L,PLT 35(13~172)×10^9/L,乳酸脱氢酶2 721(803~17 370)U/L,外周血中位原始细胞比例0.40(0.03~0.76),骨髓中位原始细胞比例0.840(0.295~0.945)。10例患者接受利妥昔单抗联合短疗程、高强度化疗,其中2例患者巩固化疗后行自体造血干细胞移植。所有治疗患者1个疗程CR率为100%,4年总生存率为90%,4年无复发生存率为90%。所有治疗患者中,只有1例患者在诱导化疗中出现肿瘤溶解综合征,经血液透析等治疗后肾功能恢复。无治疗相关性死亡病例。结论利妥昔单抗联合短疗程、高强度方案治疗成人Burkitt白血病疗效及安全性均较为理想。

Objective This study aimed to explore the efficacy and safety of rituximab combined with short-course and intensive regimens in the treatment of adult patients with Burkitt leukemia.Methods The clinical data of 11 Burkitt leukemia patients in our hospital from January 30,2006,to September 12,2018,were collected.The clinical details,complete remission(CR)rate,overall survival(OS),relapse-free survival(RFS),and adverse events were evaluated.Results The median age of 11 patients was 34(15-54)years,of which six were males and five were females(M∶F,1.2∶1).The median white blood cell(WBC)count was 12.28(2.21-48.46)×10^9/L,and the median blast percent of peripheral blood and bone marrow were 40%(3%-76%)and 84.0%(29.5%-94.5%),respectively.Ten patients were administered with rituximab combined with a short-course and intensive regimens,and two patients underwent autologous hematopoietic stem cell transplantation following consolidation chemotherapy.The CR rate after one cycle of induction therapy was 100%,the four-year OS was 90%,and RFS was 90%.Out of the ten treated patients,only one patient suffered from tumor lysis syndrome during the induction chemotherapy.Consequently,renal function recovered after hemodialysis and other treatments.The regimen is safe with no treatment-related deaths.Conclusions Rituximab combined with short-course and intensive chemotherapy regimens is effective and well-tolerated in adult Burkitt leukemia.