GDP方案治疗复发难治性非霍奇金淋巴瘤效果观察
Efficacy observation of GDP regimen for treatment of relapsed and refractory non-Hodgkin lymphoma
目的 探讨GDP方案治疗复发难治性非霍奇金淋巴瘤的疗效.方法 回顾性分析2009年1月至2014年6月北京大学第三医院收治的40例复发难治性非霍奇金淋巴瘤患者的临床资料,所有患者接受GDP方案(吉西他滨、地塞米松、顺铂)治疗.对患者临床特征及实验室指标进行分析,同时进行生存分析.结果40例患者的治疗总有效率为67.5%(27/40),完全缓解率为27.5%(11/40),部分缓解率为40.0%(16/40),3年总生存(OS)率为86.5%,5年OS率为28.8%.B细胞淋巴瘤和T细胞淋巴瘤治疗总有效率分别为69.6%(16/23)、52.9%(9/17),3年OS率分别为90.9%、80.7%,差异均无统计学意义(P=0.283,P=0.480);胃肠道受累患者治疗完全缓解率优于非胃肠道受累患者,差异有统计学意义(P=0.049),3年OS率略优于非胃肠道受累患者(89.3%比76.2%),但差异无统计学意义(P=0.237).不良反应主要表现为血液系统不良反应,Ⅲ~Ⅳ级粒细胞减少发生率为47.5%(19/40),Ⅲ~Ⅳ级血小板减少发生率为40.0%(16/40),Ⅲ~Ⅳ级贫血发生率为17.5%(7/40);非血液系统不良反应主要表现为轻度恶心、呕吐.结论 GDP方案治疗复发难治性非霍奇金淋巴瘤效果较好,起效快,耐受性好,对胃肠道受累患者疗效更好.
更多Objective To analyze the efficacy of GDP regimen for treatment of relapsed and refractory non-Hodgkin lymphoma (NHL). Methods The clinical data of 40 patients with relapsed and refractory NHL in the Third Hospital of Peking University from January 2009 to June 2014 were retrospectively analyzed. All the patients underwent GDP regimen (gemcitabine, dexamethasone, cisplatin). The clinical features, laboratory data and survival status were analyzed. Results The overall response rate (ORR) of 40 patients was 67.5 % (27/40) with 27.5 % (11/40) complete remission (CR) rate and 40.0 %(16/40) partial remission rate. The 3-year overall survival (OS) rate was 86.5 % and the OS rate of 5-year was 28.8 %. The ORR and 3-year OS rate in B-cell lymphoma and T-cell lymphoma were 69.6 % (16/23) vs. 52.9 % (9/17) (P=0.283), 90.9%vs. 80.7%(P=0.480). The CR rate in patients with gastrointestinal tract involvement was better than that in patients without gastrointestinal tract involvement (P= 0.049). Meanwhile, the patients with gastrointestinal tract involvement were superior in 3-year OS rate (89.3%vs. 76.2%, but the difference was not statistically significant (P = 0.237). The major side effect was hematological adverse reactions. The incidence of grade Ⅲ/Ⅳ neutropenia was 47.5 %, the rate of Ⅲ/Ⅳthrombocytopenia was 40.0%and the rate ofⅢ/Ⅳanemia was 17.5%. Non-hematological adverse reactions included mild nausea and vomiting. Conclusions GDP regimen is effective and well tolerated in relapsed and refractory NHL with better efficacy for gastrointestinal tract involvement NHL patients.
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