沙利度胺联合氟达拉滨、米托蒽醌与地塞米松治疗慢性淋巴细胞增殖性疾病6例

目的：观察沙利度胺联合氟达拉滨、米托蒽醌与地塞米松治疗慢性淋巴细胞增殖性疾病（chronic lymphoproliferative disorders，CLPD）的临床疗效和不良反应。方法：CLPD患者6例（男性5例，女性1例），年龄52～78岁，中位年龄72．5岁。治疗方案为沙利度胺50mg·d^-1，晚顿服，逐渐递增剂量，最大剂量200mg·d^-1；氟达拉滨25mg·m^2·d^-1，静脉滴注，第1～3天；米托蒽醌10mg，静脉滴注，第1天；地塞米松20mg或40mg，晨顿服，第1～4天。结果：6例患者共完成33个疗程的治疗，中位随访期28个月（1～31个月），3例完全缓解，3例部分缓解。主要不良反应为血液系统和消化道毒性反应。结论：沙利度胺联合氟迭拉滨、米托蒽醌、地塞米松为治疗慢性淋巴细胞增殖性疾病有效、安全的方案。

Thalidomide in Combination with Fludarabine,Mitoxantrone,Dexamethasone in the Treatment of Patients with Chronic Lymphoprolifcrative Disorders:Report of Six Cases

Objective： To evaluate the efficacy and toxicity of thalidomide combined with fiudarabine, mitoxantrone, dexamethasone in the treatment of patients with chronic lymphoproliferative disorders （CLPD）. Methods： Six patients with CLPD were enrolled in the study, 5 were male and 1 was female, with ages ranging from 58 to 78 years （median,72.5 years）. Patients received thalidomide 50 mg orally every night, increasing dosage step by step with maximum 200 mg·d^-1, fiudarabine 25mg·m-2·d^-1 intravenously （Ⅳ） on days 1 to 3,mitoxantrone 10 mg Ⅳ on day 1 ,and dexamethasone 20 mg · d ^-1 or 40 mg · d^-1 orally days 1 to 4. Courses were repeated every 4-6 weeks with thalidomide as baseline therapy. Results： Total 33 courses were fulfilled among 6 patients, the median follow-up time was 28 months with ranging from 1 month to 31 months, the complete remission rate was 50%（3/6）, the partial remission rate was 50% （3/6）, the overall response rate is 100%; no severe adverse effects were observed. Conelusion： Thalidomide combining with fiudarabine, mitoxantrone, dexamethasone in the treatment of patient with CLPD could be an effective and safety regimen.