伊布替尼治疗B细胞淋巴瘤的疗效及停药原因分析

Analysis of the Efficacy of Ibrutinib in the Treatment of B-cell Lymphoma and the Reasons for Discontinuation

目的观察伊布替尼在国内用于治疗B细胞淋巴瘤的疗效、停药情况和不良反应。方法回顾性收集我院接受伊布替尼治疗的门诊或住院B细胞淋巴瘤患者的资料。接受伊布替尼治疗后评估其疗效及停药率,分析停药原因及不良反应情况,对比国内外停药率及原因。结果所有患者的总停药率为40.28%(29/72)。套细胞淋巴瘤(MCL)患者的客观缓解率(ORR)为54.55%(12/22),停药率为36.36%(8/22);慢性淋巴细胞白血病/小淋巴细胞淋巴瘤(CLL/SLL)患者的ORR为86.96%(20/23),停药率为17.39%(4/23);弥漫大B细胞淋巴瘤(DLBCL)患者的ORR为33.33%(9/27),停药率62.96%(17/27)。与国外数据对比,我院B细胞淋巴瘤患者使用伊布替尼后不良反应发生率和停药率都低于国外,停药原因大多与疾病进展和不良反应有关。结论伊布替尼对B细胞淋巴瘤疗效较好,但是存在一定的不良反应,会导致部分患者的停药,其中原因可能与随访时间长短、患者年龄等有关。

OBJECTIVE To observe the efficacy,drug withdrawal and adverse reactions of ibrutinib in the treatment of B-cell lymphoma in China.METHODS The outpatient or inpatient data of lymphoma patients who were treated by ibrutinib in our hospital was retrospectively collected,observed the efficacy and the drug withdrawal rate in patients with lymphoma treated by ibrutinib,and analyzed the reasons for withdrawal and adverse reactions,compared the causes at home and abroad.RESULTS The total drug withdrawal rate was 40.28%(29/72).The ORR of MCL patients was 54.55%(12/22),the withdrawal rate was 36.36%(8/22);The ORR of CLL/SLL patients was 86.96%(20/23),the withdrawal rate was17.39%(4/23);the ORR of DLBCL patients was 33.33%(9/27),the withdrawal rate was 62.96%(17/27).Compared with foreign data,the incidence of adverse reactions and drug withdrawal rate were lower than those abroad,and the major reasons for drug withdrawal of ibrutinib in our hospital were related to disease progression and adverse reactions.CONCLUSION Ibrutinib have efficacy in treatment with B-cell lymphoma,especially in CLL/SLL and MCL patients,Ibrutinib induced certainly adverse reactions during medication,which may lead to drug withdrawal in some patients,and the reason may be related to the length of follow-up and the age of patients.