利妥昔单抗联合CHOP化疗方案治疗B细胞非霍奇金淋巴瘤的临床观察

Clinical efficacy of rituximab combined with CHOP chemotherapy in treatment of B-cell non-Hodgkin lymphoma

目的探讨利妥昔单抗联合环磷酰胺、阿霉素或表阿霉素、长春新碱、强的松(CHOP)化疗方案治疗B细胞非霍奇金淋巴瘤的临床效果。方法回顾性纳入2017年1月至2020年12月南阳医学高等专科学校第一附属医院收治的B细胞非霍奇金淋巴瘤患者82例。根据治疗方案分为CHOP化疗组和利妥昔单抗联合CHOP化疗组,每组41例。比较两组患者治疗6个周期后的临床疗效,治疗前和治疗6个周期后的免疫功能,以及治疗期间不良反应发生情况。结果治疗6个周期后,利妥昔单抗联合CHOP化疗组患者临床总有效率(82.93%)高于CHOP化疗组(56.10%),P<0.05。与治疗前比较,两组患者治疗6个周期后T细胞亚群CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均降低,CD8^(+)升高(P<0.05);利妥昔单抗联合CHOP化疗组患者治疗6个周期后免疫球蛋白IgA、IgG、IgM均降低(P<0.05)。治疗6个周期后,利妥昔单抗联合CHOP化疗组患者免疫球蛋白IgA、IgG、IgM低于CHOP化疗组(P<0.05)。利妥昔单抗联合CHOP化疗组患者不良反应发生率与CHOP化疗组比较,差异未见统计学意义(P>0.05)。结论与CHOP化疗方案比较,利妥昔单抗联合CHOP化疗方案治疗B细胞非霍奇金淋巴瘤可提高临床有效率,却未增加治疗期间不良反应发生率,安全性较高。

Objective To investigate rituximab combined with cyclophosphamide,doxorubicin,vincristine,and prednisone(CHOP)chemotherapy regimen in the treatment of B-cell non-Hodgkin lymphoma.Methods A total of 82 patients with B-cell non-Hodgkin lymphoma treated in the First Affiliated Hospital of Nanyang Medical College from January 2017 to December 2020 were retrospectively included.According to treatment schemes,they were divided into CHOP chemotherapy group and rituximab combined with CHOP chemotherapy group,with 41 cases in each group.The clinical efficacy was compared between the two groups after 6 cycles of treatment,immune function before and after 6 cycles of treatment,and the occurrence of adverse reactions during treatment.Results After 6 cycles of treatment,the total clinical effective rate of rituximab combined with CHOP chemotherapy group(82.93%)was higher than that of CHOP chemotherapy group(56.10%),P<0.05.Compared with before treatment,T cell subsets CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in two groups were decreased significantly after 6 cycles of treatment,and CD8^(+)was increased(P<0.05);the levels of IgA,IgG and IgM in rituximab combined with CHOP chemotherapy group were decreased significantly after 6 cycles of treatment(P<0.05).After 6 cycles of treatment,the levels of IgA,IgG and IgM in rituximab combined with CHOP chemotherapy group were significantly lower than those in CHOP chemotherapy group(P<0.05).The incidence of adverse reactions has no significant between two groups(P>0.05).Conclusions Compared with CHOP chemotherapy regimen,rituximab combined with CHOP chemotherapy regimen in the treatment of B-cell non-Hodgkin lymphoma can significantly improve the clinical effective rate,but does not increase the incidence of adverse reactions during treatment.It has high safety.