DDGP方案治疗初治结外自然杀伤/T细胞淋巴瘤18例临床分析

DDGP regimen in the initial treatment of extranodal natural killer/T-cell lymphoma in 18 cases

目的观察DDGP方案(顺铂、地塞米松、吉西他滨、培门冬酶)治疗初治结外自然杀伤/T细胞淋巴瘤(extranodal natural killer/T-cell lymphoma,ENKL)的临床疗效及安全性。方法初治ENKL患者18例,均采用DDGP方案治疗:顺铂20mg/m2,第1~4天;地塞米松12mg/m^2,第1~5天;吉西他滨800mg/m^2,第1、8天;培门冬酶2 500u/m^2,第1天;21d为1个治疗周期,中位随访时间39个月,评价疗效及不良反应。结果 18例患者治疗1个月后,完全缓解15例,部分缓解3例,总有效率100%;治疗6个月后复发5例,其中3例死亡;13例无病生存;出现3/4度白细胞或中性粒细胞减少12例,血小板减少10例,贫血5例,未发生致死性血液毒性反应,无严重过敏反应、胰腺炎及血糖异常。结论DDGP方案治疗初治ENKL疗效好,不良反应发生率低,安全性高。

Objective To evaluate the effect and safety of DDGP(cisplatin,dexamethasone,gemcitabine,pegaspargase)regimen in the initial treatment of extranodal natural killer/T-cell lymphoma(ENKL).Methods Eighteen patients with ENKL receiving initial treatment were administrated with DDGP regimen including cisplatin 20 mg/m^2 by day 1,dexamethasone 12 mg/m^2 by day 1 to 5,gemcitabine 800 mg/m^2 by day 1 and 8,and pegaspargase 2 500 u/m^2 by day 1,21 dfor one cycle.The efficacy and toxicity were evaluated after 39-month follow-up survey.Results After treatment for1 month,the result showed complete response in 15 patients and partial response in 3,with the objective overall response rate of 100%.Five patients relapsed after 6-month treatment,in which 3 died.Thirteen patients were still alive with no evidence of disease at the end of the follow-up.Grade 3/4 leukopenia or neutropenia were both common and occurred in 12 patients,thrombocytopenia occurred in 10 patients and anemia in 5.No fatal hematologic toxicity,hypersensitivity,pancreatitis or pathoglycemia was found.Conclusion DDGP regimen is effective and safe in the initial treatment of ENKL with low adverse reaction rate.