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目的:观察口服氟达拉滨治疗慢性淋巴细胞白血病/小淋巴细胞瘤(chronic lymphocytic leukemia/smalllymphocytic lymphoma,CLL/SLL)患者的疗效及耐受性。方法:患者口服氟达拉滨片40 mg/(m2.d),连续5 d,每4周一个疗程。根据美国国立癌症综合网络(National Comprehensive Cancer Network,NCCN)中CLL/SLL治疗指南标准判断疗效。结果:22例患者接受了治疗,每例患者中位疗程为4疗程。完全缓解(complete response,CR)率40.9%(9/22),部分缓解(partial response,PR)率45.5%(10/22),总有效(overall response,OR)率86.4%(19/22)。17例初治患者中CR 7例(41.2%),PR 8例(47.0%)。5例复治患者中2例CR,2例PR。中位随访24个月,患者生存率为81.8%。主要的不良反应为骨髓抑制和感染。7例(31.8%)患者发生I～III级的中性粒细胞减少,3例(13.6%)患者发生感染。非血液学毒性轻微。不良反应均可恢复。结论:口服氟达拉滨对于CLL/SLL患者安全、有效,并且耐受性较好。
Objective: To observe the efficacy and tolerability of oral fludarabine in patients with chronic lymphocytic leukemia / small lymphocytic lymphoma (CLL / SLL). Methods: Patients received fludarabine 40 mg / (m2.d) orally for 5 consecutive days every 4 weeks. Efficacy was assessed according to the CLL / SLL guidelines for treatment in the National Comprehensive Cancer Network (NCCN). Results: Twenty-two patients were treated, and the median course of treatment was 4 courses per patient. The complete response (CR) rate was 40.9% (9/22), partial response (PR) rate was 45.5% (10/22), and the overall response (OR) rate was 86.4% (19/22) . Of the 17 newly diagnosed patients, 7 were CR (41.2%) and 8 were PR (47.0%). Among the 5 retreatment patients, 2 were CR and 2 were PR. The median follow-up of 24 months, the patient survival rate was 81.8%. The main adverse reactions were myelosuppression and infection. Seven patients (31.8%) developed grade I to III neutropenia and three (13.6%) patients developed infection. Non-hematologic toxicity is mild. Adverse reactions can be restored. Conclusion: Fludarabine is safe, effective and well tolerated in CLL / SLL patients.