利妥昔单抗联合CHOP方案化疗对恶性淋巴瘤患儿的治疗效果

Therapeutic effect of rituximab combined with CHOP regimen chemotherapy in children with malignant lymphoma

目的 探讨利妥昔单抗联合环磷酰胺+表柔比星+长春新碱+泼尼松(CHOP)方案化疗对恶性淋巴瘤患儿的治疗效果。方法 根据治疗方式的不同将80例恶性淋巴瘤患儿分为对照组(n=36)和观察组(n=44),对照组患儿采取CHOP方案化疗,观察组患儿在对照组的基础上给予利妥昔单抗治疗。比较两组患儿的临床疗效、肿瘤标志物[肿瘤坏死因子-α(TNF-α)及血小板衍生生长因子-BB(PDGF-BB)]水平、血常规指标[白细胞(WBC)、血红蛋白(Hb)、血小板(PLT)]、脏器功能异常情况、不良反应发生情况及预后。结果 观察组患儿的总有效率明显高于对照组(P﹤0.01)。治疗后,两组患儿TNF-α、PDGF-BB水平均低于本组治疗前,观察组患儿TNF-α、PDGF-BB水平均低于对照组,差异均有统计学意义(P﹤0.05)。治疗后,两组患儿WBC水平均低于本组治疗前,Hb、PLT水平均高于本组治疗前,观察组患儿WBC水平低于对照组,Hb、PLT水平均高于对照组,差异均有统计学意义(P﹤0.05)。两组患儿肝功能异常、肾功能异常、心脏超声异常、甲状腺功能异常发生率及不良反应总发生率比较,差异均无统计学意义(P﹥0.05)。随访3年,观察组患儿的肿瘤复发转移率低于对照组(P﹤0.05)。结论 利妥昔单抗联合CHOP方案化疗可提高恶性淋巴瘤患儿的治疗效果,改善血常规指标,降低肿瘤复发转移率,且不会增加不良反应发生率及脏器功能损害。

Objective To investigate the therapeutic effect of rituximab combined with cyclophosphamide+epirubi-cin+vincristine+prednisone(CHOP)regimen chemotherapy in children with malignant lymphoma.Method A total of 80 children with malignant lymphoma were divided into the control group(n=36)and the observation group(n=44).The children in the control group received CHOP regimen chemotherapy,and the children in the observation group received rituximab based on the control group’s therapy.The clinical efficacy,tumor markers[tumor necrosis factorα(TNF-α)and platelet-derived growth factor-BB(PDGF-BB)]levels,blood routine indicators[white blood cell(WBC),hemoglobin(Hb),platelet(PLT)],abnormal organ function,adverse events,and prognosis were compared between the two groups.Result The total effective rate of the observation group was significantly higher than that of the control group(P<0.01).After the treatment,the levels of TNF-αand PDGF-BB in the two groups were lower than those before the treatment,and the levels of TNF-αand PDGF-BB in the observation group were lower than those in the control group,and the differenc-es were statistically significant(P<0.05).After the treatment,the levels of WBC in the two groups were lower than those before the treatment,and the levels of Hb and PLT were higher than those before the treatment,the level of WBC in the observation group was lower than that in the control group,and the levels of Hb and PLT were higher than those in the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the inci-dence of abnormal liver function,renal function,cardiac ultrasound,thyroid function,and the total incidence of adverse events between the two groups(P>0.05).During the three-year follow-up,the rate of tumor recurrence and metastasis in the observation group was lower than that in the control group(P<0.05).Conclusion Rituximab combined with CHOP regimen chemotherapy could improve the therapeutic effect of children with malignant lymphoma,improve blood routine indicators,and reduce the risk of tumor recurrence and metastasis.Meanwhile,the regimen will not increase the incidence of adverse events and harm organ function.