GDPT与CHOP方案一线治疗间变大细胞淋巴瘤亚型的疗效比较

Comparison of the curative effecty of GDPT and CHOP regimens in the first-line treatment of subtypes of anaplastic large cell lymphoma

目的:探讨GDPT与CHOP方案一线治疗间变大细胞淋巴瘤(anaplastic large cell lymphoma,ALCL)不同亚型的疗效比较。方法:收集45例ALCL患者,22例应用GDPT方案,23例应用CHOP方案。结果:16例应用GDPT与CHOP方案的ALK(+)ALCL患者ORR、OS和PFS无统计学差异(P> 0.05);29例应用GDPT方案与CHOP方案的ALK(-)ALCL患者ORR(P=0.028)与OS(P=0.036)均有统计学差异,PFS无统计学差异(P> 0.05)。相比CHOP方案,GDPT的患者心脏损伤发生率低,差异有统计学意义(P=0.039)。单因素分析显示ALK蛋白表达和Ann Arbor分期与预后有关。多因素分析显示年龄和乳酸脱氢酶(LDH)是ALCL患者的独立预后因素。结论:GDPT较CHOP方案治疗ALCL患者总体反应率高,耐受性好,不良反应少;但对ALK(+)ALCL患者,两种方案疗效相当;而对ALK(-)ALCL患者,前者疗效更优。年龄及LDH水平是ALCL患者的独立预后因素。

Objective:To explore the comparison of the curative effect of GDPT and CHOP regimens in the first-line treatment of different subtypes of anaplastic large cell lymphoma(ALCL).Methods:45 ALCL patients were collected,22 of which applied the GDPT program,and 23 of them applied the CHOP program.Results:16 ALK(+) ALCL patients who applied GDPT and CHOP had no significant difference in ORR,OS,and PFS(P>0.05);29 cases used GDPT The ORR(P = 0.028) and OS(P = 0.036) of ALK(-) ALCL patients between the protocol and the CHOP protocol were statistically different,and there was no statistical difference in PFS(P>0.05).Compared with the CHOP program,the incidence of heart injury in GDPT patients was lower,and difference between the two groups has statistical significance(P = 0.039).Univariate analysis showed that ALK protein expression and Ann Arbor staging were related to prognosis.Multivariate analysis showed that age and lactate dehydrogenase are independent prognostic factors for ALCL patients.Conclusion:Compared with the CHOP regimen,GDPT has a higher overall response rate,better tolerability,and fewer adverse reactions.However,for patients with ALK(+) ALCL,the two regimens have the same effect;for patients with ALK(-) ALCL,the former has a better effect.excellent.Age and LDH level are independent prognostic factors for ALCL patients.