摘要目的 探讨COPADM方案在伯基特淋巴瘤(Burkitt lymphoma,BL)治疗中的远期疗效.方法 回顾性分析2006年4月至2017年6月间确诊的39例BL患者临床资料,比较COPADM方案组及对照组(其他治疗方案)患者生存情况及不良反应发生情况.结果 ①39例患者中,男26例,女13例,中位年龄30(11～63)岁,其中年龄≤40岁者25例,年龄＞40岁者14例;Ann Arbor分期Ⅲ～Ⅳ期33例;13例患者有B症状(发热、盗汗、体重减轻);IPI评分≥3分25例.②COPADM组20例,3年总生存(OS)及无事件生存(EFS)率分别为(83.5±2.6)％、(73.2±3.1)％,对照组19例,3年OS及EFS率分别为(47.4±2.4)％、(42.1土2.4)％,两组OS、EFS间差异均有统计学意义(P值均＜0.001).③COPADM组中年龄≤40岁者12例,3年OS及EFS率分别为(93.7±3.9)％、(83.3±5.4)％;年龄＞40岁者8例,3年OS及EFS率分别为(48.3±8.5)％、(37.6土6.0)％,年龄≤40岁者OS、EFS显著优于年龄＞40岁者(P值分别为0.004、0.045).④24例患者联合利妥昔单抗治疗,3年OS及EFS率分别为(73.9±9.2)％、(69.9±9.6)％;15例未联合利妥昔单抗治疗,3年OS、EFS率分别为(51.3±13.3)％、(38.1±12.9)％,两组间OS、EFS差异有统计学意义(P值分别为0.042、0.008).结论 COPADM方案化疗可以延长BL患者生存期;利妥昔单抗的联合应用可进一步改善患者预后;年龄＞ 40岁患者预后明显差于年龄≤40岁患者.

abstractsObjective To investigate the long term efficacy of COPADM regimen in the treatment of Burkitt lymphoma (BL).Methods The clinical data of 39 patients with BL from April 2006 to June 2017 were retrospectively analyzed.According to different chemotherapy regimens,the patients were divided into COPADM group and control group.Results ①Of 39 BL patients,26 were male and 13 female.The median age was 30 (11-63) years old,including 25 younger than 40 and 14 older than 40.Among them,33 patients were in stage Ⅲ-Ⅳ,13 patients had B symptoms and 25 patients were IPI score≥3.② Twenty patients treated with COPADM regimen (COPADM group),the 3 year overall survival (OS)and progression-free survival (PFS) were (83.5±2.6)％ and (73.2±3.1)％,respectively.Nineteen patients in the control group had a 3-year OS and EFS of (47.4±2.4) ％ and (42.1±2.4) ％,respectively.There were significant differences in OS and EFS between the two groups (all P＜ 0.001).③ Of the 20 patients in COPADM group,12 were younger patients (age≤40 years),their 3-year OS and EFS were (93.7±3.9)％ and (83.3±5.4)％,respectively.The other 8 patients were older than 40 years old,and their 3-year OS and EFS were (48.3±8.5) ％,(37.6±6.0) ％,respectively.Both OS and EFS in younger patients was significantly better than older patients (P =0.004,P =0.045).④ There were 24 patients treated with combination of Rituximab,their 3-year OS and EFS were (73.94±9.2)％ and (69.9±9.6)％,respectively.The other 15 patients were treated without Rituximab,and their 3-year OS and EFS were (51.3± 13.3) ％ and (38.1± 12.9) ％,respectively.There were significant differences in OS and EFS between the two groups (P =0.042,P =0.008).Conclusion COPADM regimen may improve the efficacy of BL.COPADM combined with Rituximab enables BL patients with greater benefit.The prognosis is significantly worse in patients older than 40 years old than in those less than 40 years old.