DHAP方案治疗57例复发和难治性弥漫大B细胞淋巴瘤的单中心回顾性分析

Single center retrospective analysis on DHAP regimen for 57 patients with recurrent and refractory diffuse large B-cell lymphoma

目的探讨DHAP(顺铂、阿糖胞苷、地塞米松)挽救化疗方案治疗复发和难治性弥漫大B细胞淋巴瘤(R/R DLBCL)的有效性及安全性。方法57例R/R DLBCL患者接受DHAP方案化疗,收集其临床资料和预后信息,回顾性研究该方案疗效、安全性和预后相关因素。结果57例患者的客观缓解率为61.4%,细胞来源为生发中心亚型的患者短期疗效优于非生发中心亚型的患者(P=0.022)。中位PFS为4.3(95%CI:3.725~4.875)个月,中位OS为12.6(95%CI:6.962~18.238)个月。1年总生存率为49.1%,2年总生存率为28.9%。多因素分析提示Ann Arbor分期Ⅲ~Ⅳ期是OS的独立影响因素。结论DHAP仍是R/R DLBCL的有效挽救化疗方案,但存在缓解期短、有效率较低、副反应较重等缺点。

Objective To investigate the efficacy and safety of DHAP(cisplatin,cytarabine,dexamethasone)regimen for R/R DLBCL.Methods A total of 57 patients with R/R DLBCL received DHAP regimen.The clinical data and prognostic information were collected,and the efficacy,safety and prognostic factors were studied retrospectively.Results The objective response rate of 57 patients was 61.4%.The short-term efficacy of patients with lymphoma originated from germinal center was better than that of patients with non-germinal center derived lymphoma(P=0.022).The median PFS was 4.3(95%CI:3.725~4.875)months,and the median OS was 12.6(95%CI:6.962~18.238)months.The 1-year overall survival rate was 49.1%,and the 2-year overall survival rate was 28.9%.Multivariate analysis showed that Ann Arbor stageⅢ~Ⅳwere independent factors affecting OS.Conclusion DHAP regimen is still an effective salvage chemotherapy regimen for R/R DLBCL,but it has the disadvantage of short remission period,low effective rate and serious toxicity.