三氧化二砷联合ICE方案治疗复发难治非霍奇金淋巴瘤临床观察

Clinical observation of arsenic trioxide in combination of ICE regimen for the treatment of patients with relapsed and refractory non-Hodgkin lymphoma

目的探讨三氧化二砷联合ICE方案(异环磷酰胺、顺铂、依托泊苷)治疗复发难治非霍奇金淋巴瘤(NHL)的疗效和不良反应。方法 15例复发难治性NHL患者采用三氧化二砷联合ICE方案化疗。异环磷酰胺1.2 g/m^2,静脉滴注,第1~4天;同时于异环磷酰胺后0 h、4 h和8 h应用美司那预防出血性膀胱炎,每次用量为当日异环磷酰胺的20%,静脉注射;顺铂25 mg/m^2,静脉滴注,第1~2天,足叶乙甙50 mg/m^2,静脉滴注,第1~3天,亚砷酸10 mg,静脉滴注,第5~18天;21~28 d为一个周期,每例患者至少完成两个周期以上治疗。观察疗效和不良反应。结果 15例患者中完全缓解5例,部分缓解4例,疾病稳定4例,疾病进展2例,临床总有效率为60%。主要不良反应为骨髓抑制,Ⅲ~Ⅳ度白细胞减少为12例(80.0%)。结论三氧化二砷联合ICE方案治疗复发难治性NHL临床效果满意,值得临床推广。

Objective To explore the clinical effect and side effect of patients with relapsed and refractory non-Hodgkin lymphoma(NHL) treated by arsenic trioxide in combination of ICE regimen(ifosfamide, cisplatin, etoposide). Methods Fifteen patients with relapsed and refractory non-Hodgkin 1ymphoma were treated with arsenic trioxide in combination of ICE regimen(Ifosfamide 1.2 g/m^2, intravenous drip, d1~4; At the same time, mesna was applied to prevent hemorrhagic cystitis 0 h, 4 h and 8 h after ifosfamide, with dosage of 20% of that of ifosfamide, intravenous injection; Cisplatin 25 mg/m^2, intravenous drip, d1~2; Etoposide 50 mg/m^2, intravenous drip, d1~3; Arsenic trioxid 10 mg, intravenous drip, d5~18; 21~28 d in one cycle). The clinica1 effect and side effect of patients who received at least 2cycles were evaluated. Results In 15 cases, there were complete response(CR) in 5 cases(33.3%),partial response(PR) in 4 cases(26.7%), stable disease(SD) in 4 cases(26.7%), and progressive disease(PD) in 2 cases(13.3%). The total clinical effective rate was 60.0%(9/15). Major side effects was bone marrow suppression, and WHO grade Ⅲ/Ⅳ leukopenia were developed in 12 patients(80.0%). Conclusion Arsenic trioxide in combination of ICE regimen in the treatment of relapsed and refractory non-Hodgkin lymphoma has satisfactory clinical results and is worthy of promotion.