卡瑞利珠单抗治疗霍奇金淋巴瘤的近期疗效及安全性

Short-term efficacy and safety of Carelizumab in the treatment of Hodgkin′s lymphoma

目的探讨程序性死亡受体1抑制剂卡瑞利珠单抗治疗霍奇金淋巴瘤的近期疗效及安全性。方法选择2017年1月至2020年5月在周口市中心医院接受多柔比星+博来霉素+长春新碱+达卡巴嗪(ABVD)一线化学治疗方案治疗失败的84例霍奇金淋巴瘤患者为研究对象,根据治疗方法将患者分为对照组(n=50)和观察组(n=34)。对照组患者接受表柔比星+长春地辛+达卡巴嗪化学治疗,观察组患者接受卡瑞利珠单抗治疗。比较2组患者化学治疗4个周期后的临床疗效、不良反应发生情况及随访2 a内生存情况。结果化学治疗4个周期后,观察组患者的疾病控制率和客观缓解率显著高于对照组(χ^(2)=4.019、11.213,P<0.05)。治疗期间,观察组患者血液系统毒性Ⅰ~Ⅱ级发生率及非血液系统毒性Ⅲ~Ⅳ级发生率显著低于对照组(P<0.05)。对照组患者Ⅲ级以上不良反应中血液系统毒性占10.00%,非血液系统毒性占18.00%;观察组患者Ⅲ级以上不良反应中仅发现有中性粒细胞减少和肝功能异常,各占2.94%。随访2 a内,对照组患者死亡12例(24.00%),观察组患者死亡2例(5.88%);观察组患者的病死率显著低于对照组(χ^(2)=4.783,P<0.05)。结论卡瑞利珠单抗治疗ABVD方案治疗失败的霍奇金淋巴瘤可增强近期抗肿瘤效果,提高患者生存率,且安全性较高。

Objective To investigate the short-term efficacy and safety of Carelizumab of a programmed cell death 1 inhibitor in the treatment of Hodgkin′s lymphoma.Methods A total of 84 patients with Hodgkin′s lymphoma who failed to receive the first-line doxorubicin+bleomycin+vincristine and dacarbazine(ABVD)regimen in Zhoukou Central Hospital from January 2017 to May 2020 were selected as the study subjects,and they were divided into the control group(n=50)and the observation group(n=34)according to treatment methods.The patients in the control group received epirubicin+vindesine+dacarbazine regimen,and the patients in the observation group received Carelizumab.The clinical efficacy after 4 cycles of chemotherapy,adverse reactions and survival within 2 years of follow-up were compared between the two groups.Results After 4 cycles of chemotherapy,the disease control rate and objective remission rate of patients in the observation group were significantly higher than those in the control group(χ^(2)=4.019,11.213;P<0.05).During the treatment,the incidence of gradeⅠ-Ⅱhematological toxicity and gradeⅢ-Ⅳnon-hematological toxicity of patients in the observation group were significantly lower than those in the control group(P<0.05).The hematological toxicity accounted for 10.00%and the non-hematological toxicity accounted for 18.00%of the adverse reactions above gradeⅢin the control group;only neutropenia and abnormal liver function in the adverse reactions above gradeⅢwere found in the observation group,which accounted for 2.94%,respectively.During 2-year follow-up,12 patients(24.00%)in the control group died,while 2 patients(5.88%)in the observation group died;the mortality of patients in the observation group was significantly lower than that in the control group(χ^(2)=4.783,P<0.05).Conclusion Carelizumab can enhance the short-term anti-tumor effect and improve the survival rate of patients with Hodgkin′s lymphoma who failed to ABVD regimen,and it has high safety.