R-CHOP方案治疗复发、难治弥漫大B细胞淋巴瘤的临床研究

 【摘要】　目的　观察R-CHOP方案治疗复发、难治弥漫大B细胞淋巴瘤（DLBCL）的临床疗效及患者不良反应。方法　选择30例经病理证实为CD20阳性的DLBCL患者，前期常规方案化疗（不含利妥昔单抗）2～6个疗程后评估为复发或难治患者，其中复发患者16例，难治患者14例。应用R-CHOP方案治疗4～6个周期，每个周期21 d。所有淋巴瘤患者均为Ⅲ～Ⅳ期，搜集治疗前后相关临床资料，采用回顾性分析方法，将R-CHOP方案疗效与文献及自身对照比较，评价其疗效及不良反应。结果　全组30例患者均可评价疗效，完全缓解15例，部分缓解10例，稳定3例，进展2例，完全缓解率为50.0 %（15／30），总有效率83.3 %（25／30）。出现Ⅱ度白细胞减少3例，Ⅰ度血小板降低1例，恶心等轻微的消化道反应2例。结论　R-CHOP方案对复发、难治DLBCL仍有良好的治疗效果，完全缓解率与总有效率明显优于常规二线化疗方案。接受R-CHOP方案治疗患者不良反应轻微，与常规化疗方案无显著区别，患者耐受良好。

Clinical study of R-CHOP regimen for relapsed and refractory diffuse large B cell lymphoma

Objective To evaluate the clinical efficacy and toxicity of rituximab combined with CHOP （R-CHOP） in the treatment of relapsed or refractory diffuse large B cell lymphoma （DLBCL）. Methods 30 patients were enrolled. All patients, pathologically confirmed to be CD20 positive DLBCL （all in stages IU-IV ）, were relapsed or refractory after received 2-6 cycles of chemotherapy. Then all of them received R-CHOP schedule for 4 to 6 cycles, each cycle was 21 days. Clinical data before and after R-CHOP were collected. A retrospective analysis of the R-CHOP therapy, either compared to the literature or self-control was performed to evaluate the efficacy and toxicity. Results All the 30 patients were evaluable, induding 15 cases were complete remission （CR）, 10 cases were partial remission （PR）, 3 cases were stable disease （SD）, and 2 cases were progressed disease （PD）. The CR rate was 50.0 % （15/30）, the total response rate （RR） was 83.3 % （25/30）. All patients were well tolerated to the therapy. Only 3 cases were Ⅱ degree neutropenia, 1 case was I degree thrombocytopenia, and 2 cases suffered nausea and other mild gastrointestinal discomfort. Conclusions R-CHOP regimen could also achieve good response for relapsed or refractory DLBCL significantly. The commorl adverse effects of rituximab were mild. All the patients were well tolerated.