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目的 :观察利妥昔单抗联合环磷酰胺、长春新碱、多柔比星及泼尼松 (CHOP方案 )治疗新诊断的弥漫性大B细胞性淋巴瘤 (DLBL)的临床疗效。 方法 :2 0 0 2年 4月至 2 0 0 3年 2月 ,共 5 2例病人进入本研究。化疗采用标准的CHOP方案 :d 1,环磷酰胺 6 0 0mg·m- 2 ,长春新碱 1.4mg·m- 2 ,多柔比星 2 5mg·m- 2 ,泼尼松 6 0mg·m- 2 × 5d ,每 3wk一个疗程 ,共 6个疗程。利妥昔单抗静脉滴注剂量为 375mg·m- 2 ,于化疗第一个疗程前 2d开始 ,每周输注 1次 (连续输注 ) ,连续 4次 (标准剂量 )或 6次 (增强剂量 ) ;或于每疗程的CHOP方案化疗前 2d输注 ,每 3周 1次 (间隔输注 ) ,输注 4次 (标准剂量 )或 6次 (增强剂量 )。结果 :5 0例病人进入临床疗效评估 ,6 0 %获得完全缓解 ,总有效率为 10 0 %。其中 ,34例AnnArbor分期为Ⅲ期或Ⅳ期的病人有15例获得完全缓解 ,完全缓解率为 4 4%。 5 0例病人共随访了 (8±s 5 )wk ,2～ 30wk ,病人 16wk的无病生存 (PFS)率为 87%。标准剂量组和增强剂量组疗效无显著差异 ,连续输注和间隔输注疗效差异亦无显著意义 (P >0 .0 5 )。所有病人在治疗过程中对本方案均能较好耐受 ,主要的不良反应为输注相关的不良反应 (32 % )和化疗相关的血液学不良反应 (2 0 % )。 结论 :利妥昔单?
Objective: To observe the clinical efficacy of rituximab combined with cyclophosphamide, vincristine, doxorubicin and prednisone (CHOP regimen) in the treatment of newly diagnosed diffuse large B-cell lymphoma (DLBL). METHODS: From April 2002 to February 2003, a total of 52 patients entered the study. Chemotherapy with standard CHOP program: d 1, cyclophosphamide 600 mg · m-2, vincristine 1.4mg · m-2, doxorubicin 25mg · m-2, prednisone 60mg · m- 2 × 5d, every 3wk a course of treatment, a total of 6 courses. Rituximab intravenous infusion of 375mg · m-2, 2d before the first course of chemotherapy, once a week infusion (continuous infusion), 4 times (standard dose) or 6 times (enhanced Dose) or 2-day infusion of CHOP regimen prior to each course of treatment, once every 3 weeks (interval infusion), 4 times (standard dose) or 6 times (booster dose). Results: Fifty patients entered the clinical evaluation, 60% achieved complete remission, with a total effective rate of 10%. Among them, 34 patients with AnnArbor stage Ⅲ or Ⅳ achieved complete remission in 15 patients, and the complete remission rate was 44%. A total of 50 patients were followed up for (8 ± s 5) weeks and 2 to 30 weeks. The 16-week disease-free survival (PFS) rate was 87%. There was no significant difference between the standard dose group and the booster dose group, with no significant difference between continuous infusion and intermittent infusion (P> 0.05). All patients were well tolerated with this regimen during treatment. The main adverse reactions were infusion-related adverse reactions (32%) and chemotherapy-related adverse reactions (20%). Conclusion: Rituximab