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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.

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 Ⅲ-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 common adverse effects of rituximab were mild.All the patients were well tolerated.