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COTPE方案联合沙利度胺治疗双打击淋巴瘤疗效观察
作者:罗泉芳  唐琳洁  王薇 
单位:广西壮族自治区南溪山医院血液科  广西 桂林 541002 
关键词:淋巴瘤 B细胞/药物疗法 环磷酰胺/投药和剂量 长春新碱/投药和剂量 多柔比星/投药和剂量 泼尼松/投药和剂量 依托泊苷/投药和剂量 沙利度胺/投药和剂量 抗肿瘤联合化疗方案/治疗应用 药物疗法 联合 治疗结果 
DOI:R733.4;R730.53
出版年,卷(期):页码:2018,33(4):340-343
摘要:

目的 探讨COTPE方案联合沙利度胺治疗双打击淋巴瘤疗效及不良反应。方法 23例经病理和FISH诊断为双打击淋巴瘤的患者使用COTPE方案(环磷酰胺750 mg/m2,d1;长春新碱1.4 mg/m2,d1;吡柔比星50 mg/m2,d1;泼尼松100 mg,d1~5;依托泊苷50 mg/m2,d1~5)联合沙利度胺(100 mg/d)治疗,治疗6个周期。结果 23例中获CR 11例(47.8%),PR 6例(26.1%),SD 5例(21.7%),PD 1例(4.3%),总有效率(CR+PR)为73.9%,2年生存率为91.3%,3年生存率为65.2%。Ⅰ~Ⅱ度骨髓抑制5例(21.7%),转氨酶升高2例(8.7%),脱发19例(82.6%),消化道反应14例(60.9%),Ⅲ~Ⅳ度不良反应少。结论 COTPE方案联合沙利度胺治疗"双打击"B细胞淋巴瘤取得较好的疗效,不良反应少,患者可耐受。

Objective To analyze the efficacy and side effects of COTPE combined with thalidomide in treatment of double-hit B-cell lymphoma. Methods Twenty-three patients with double-hit B-cell lymphoma diagnosed by histopathology and FISH were included in the analysis. The patients were treated with COTPE regimen (750 mg/m2 cyclophosphamide,1.4 mg/m2 vincristine and 50 mg/m2 pirarubicin on d1,100 mg prednisone and 50 mg/m2 etoposide on d1-5),plus thalidomide (100 mg/d) for 6 cycles. Results Among 23 cases,11 achieved CR (47.8%),6 achieved PR (26.1%),5 were SD (21.7%) and one was PD (4.3%) with an overall response rate (CR+PR) of 73.9%. The 2-and 3-year survival rates were 91.3% and 65.2%,respectively. In these patients,5 developed grade Ⅰ-Ⅱ myelosuppression (21.7%),two showed elevated transaminases (8.7%),19 had alopecia (82.6%),and 14 showed gastrointestinal toxicity (60.9%). Grade Ⅲ-Ⅳ adverse effects were rarely observed. Conclusion COTPE combined with thalidomide shows favourable therapeutic efficacy for double-hit B-cell lymphoma with lower levels of adverse effects and higher patients tolerance.

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