ZR2方案治疗老年弥漫大B细胞淋巴瘤患者效果观察

Efficacy observation of ZR2 regimen for treatment of elderly patients with diffuse large B-cell lymphoma

目的探讨ZR2(泽布替尼+来那度胺+利妥昔单抗)方案治疗老年人弥漫大B细胞淋巴瘤(DLBCL)的临床疗效及安全性。方法回顾性病例系列研究。回顾性分析2021年1月至2023年2月泰兴市人民医院收治的接受ZR2方案治疗的16例老年(>65岁)非生发中心B细胞型DLBCL患者的临床资料,观察患者的疗效、不良反应发生情况及疾病转归。结果16例患者中,男性11例,女性5例,年龄[M(Q1,Q3)]76岁(70岁,78岁);Ann Arbor分期Ⅲ~Ⅳ期10例。16例患者中完全缓解9例,部分缓解4例。16例患者均出现不同程度的骨髓抑制,Ⅲ~Ⅳ级血液学不良反应包括中性粒细胞减少(7例)、血小板减少(2例),经粒细胞集落刺激因子、促血小板生成素治疗后骨髓造血恢复;Ⅱ级及以上非血液学不良反应主要有胃肠道反应(5例)、肝功能异常(3例)、外周神经炎(2例),经相应处理后均改善。2例患者因疾病进展退出此方案治疗,1例患者治疗2个疗程后因合并疾病死亡。治疗过程中未出现深静脉血栓,无心脏和肾脏不良反应。结论ZR2方案治疗老年DLBCL患者有一定效果,不良反应可耐受。

Objective To investigate the clinical efficacy and safety of ZR2(zevalin+lenalidomide+rituximab)regimen in the treatment of elderly patients with diffuse large B-cell lymphoma(DLBCL).Methods A retrospective case series study was conducted.The clinical data of 16 elderly(>65 years old)non-germinal center B-cell-like DLBCL patients treated with ZR2 regimen at the Taixing People's Hospital from January 2021 to March 2023 were retrospectively analyzed.The efficacy,adverse reactions and prognosis of patients were observed.Results Of the 16 patients,11 were male and 5 were female,with the age[M(Q 1,Q 3)]of 76 years old(70 years old,78 years old),and 10 cases were Ann Arbor stageⅢ-Ⅳ.Among the 16 patients,9 achieved complete remission,4 patients achieved partial remission.All 16 patients experienced varying degrees of reversible bone marrow suppression,gradeⅢ-Ⅳhematologic adverse reactions included neutropenia(7 cases)and thrombocytopenia(2 cases),and the bone marrow hematopoiesis recovered after treatment with granulocyte colony-stimulating factor and thrombopoietin.The main≥gradeⅡnon-hematologic adverse reactions were gastrointestinal reactions(5 cases),liver function abnormalities(3 cases)and peripheral neuropathy(2 cases),which were improved after the appropriate treatment.Two patients discontinued the treatment of this regimen due to disease progression,and 1 patient died from complications after 2 cycles of treatment.No deep vein thrombosis,cardiac toxicity or renal toxicity occurred during the treatment process.Conclusions The ZR2 regimen is effective in the treatment of elderly DLBCL patients with tolerable adverse reactions.