肿瘤药学2018，Vol.8Issue(6)：897-902,6.DOI:10.3969/j.issn.2095-1264.2018.06.14
利妥昔单克隆抗体联合GDP方案化疗治疗复发弥漫大B细胞淋巴瘤的疗效、预后和安全性分析
Efficacy, Prognosis and Safety of Rituximab Combined with GDP Regime for Patients with Relapsed Diffuse Large B-cell Lymphoma
摘要
Abstract
Objective To observe the efficacy, prognosis and safety of Rituximab (RTX) combined with Gemcitabine, dexamethasone and cisplatin (GDP) for patients with relapsed diffuse large B-cell lymphoma (DLBCL). Methods Eighty-two patients with relapsed DLBCL who were admitted to our hospital between January 2012 and January 2015 were divided into the GDP group (41 cases) and the RGDP group (41 cases) by random number table. The GDP group was treated by GDP plan, and the RGDP group was treated by GDP plan combined with RTX. The efficacy, overall survival (OS), event free survival (EFS), and the incidence of early death and adverse reactions were compared between the two groups. The multivariate Cox regression model was used to explore the independent prognostic risk factors. Results There was a statistically significant difference in the clinical efficacy between the two groups (Z=2.196, P=0.028). The ORR of the RGDP group was significantly higher than that of the GDP group (68.29% vs. 46.34 %, χ2=4.038, P=0.044). After chemotherapy, there were respectively 13 cases (31.71%) and 12 cases (29.27%) in the RGDP and GDP group receiving stem cell transplantation (χ2=0.058, P=0.810). The death risk in the RGDP group was significantly lower than in the GDP group [HR=0.534, 95% CI (0.294, 0.970), P=0.035]. The medium EFS was 15 (4~32) months in GDP group and 26 (9~35) months in RGDP group; the disease progression risk of the RGDP group was signifi-cantly lower than that of the GDP group [HR=0.556, 95% CI (0.333~0.928), P=0.020]. There were no significant differences in the inci- dence of early death (2.44% vs. 2.44%, χ2=0, P=1) and the incidence of adverse reactions above grade Ⅲ (17.07% vs. 24.09%, χ2=0.688, P=0.414) between GDP and RGDP group. Cox regression analysis showed that IPI risk grade (HR=3.373, P=0.000) was an independent risk factor for death, and that HSCT (HR=0.384, P=0.036), RTX (HR=0.507, P=0.029) were protective factors of patients with recurrent DLBCL. Conclusions Rituximab combined with GDP regimen is effective for recurrent diffuse large B-cell lymphoma. It could improve overall survival and progression-free survival of patients, and the safety is similar to the GDP plan. IPI risk classification is independent risk factor for the death of patients with recurrent DLBCL, while HSCT and RTX are its protective factors.关键词
弥漫大B细胞淋巴瘤/复发/利妥昔单抗/疗效/预后/安全性Key words
Diffuse large B-cell lymphoma/Relapse/Rituximab/Efficacy/Prognosis/Safety分类
医药卫生引用本文复制引用
木合拜尔·阿布都尔,阿孜古丽,刘虹,古再丽努尔,毛敏..利妥昔单克隆抗体联合GDP方案化疗治疗复发弥漫大B细胞淋巴瘤的疗效、预后和安全性分析[J].肿瘤药学,2018,8(6):897-902,6.基金项目
湖北省卫计委和计划生育委员会科研项目(WJ2015MB232). （WJ2015MB232）
