【摘要】：目的·研究ICE(異環(huán)磷酰胺、卡鉑、依托泊苷)方案治療復發(fā)難治性彌漫大B細胞淋巴瘤(DLBCL)患者的有效性及相關預后因素。方法·回顧性分析2004年7月—2016年6月收治的84例初發(fā)進展期及復發(fā)難治性DLBCL患者的臨床資料,給予ICE方案化療,采用Kaplan-Meier方法計算總生存期,并采用Cox回歸方法進行多因素分析。結果·84例患者中26例達完全緩解,11例達部分緩解,客觀緩解率為44.0%;獲得緩解所需的化療療程的中位數(shù)為3個(1~6個)。1年總體生存率為49.5%,2年總體生存率為30.0%,中位生存期為12.2個月。單因素分析顯示早期復發(fā)或進展(P=0.041)、IPI中高危/高危(P=0.024)及NCCN-IPI中高危/高危(P=0.002)是影響患者生存的不良因素,化療后緩解與延長患者生存顯著相關(P=0.000);多因素分析提示NCCN-IPI中高危/高危為影響患者生存的獨立危險因素,化療后緩解為延長患者生存的獨立預后指標。結論·ICE方案可作為復發(fā)難治性DLBCL患者的有效挽救性治療方案。
[Abstract]:Objective To study the efficacy and relevant prognostic factors in the treatment of patients with refractory diffuse large B-cell lymphoma (DLBCL) with ICE (heterocyclophosphamide, carboplatin, and depending on the poises) regimen. Methods The clinical data of 84 patients with advanced and refractory DLBCL from July 2004 to June 2016 were analyzed retrospectively. The overall survival was calculated by using the Kaplan-Meier method and the multi-factor analysis was performed using the Cox regression method. Results: Of the 84 patients,26 of the 84 patients had complete remission,11 had a partial response, the objective response rate was 44.0%, and the median of the chemotherapy courses required for remission was 3 (1 to 6). The overall survival rate was 49.5%, the overall survival rate of 2 years was 30.0%, and the median survival time was 12.2 months. Single factor analysis showed that early recurrence or progression (P = 0.041), high risk/ high risk in IPI (P = 0.024) and high risk/ high risk (P = 0.002) in NCCN-IPI were the adverse factors that affected the survival of patients. The multi-factor analysis indicates that the high-risk/ high-risk in the NCCN-IPI is an independent risk factor affecting the survival of the patient, and the independent prognostic indicator for prolonging the survival of the patient is relieved after the chemotherapy. Conclusion The ICE regimen can be used as an effective salvage therapy in patients with refractory DLBCL.
【作者單位】： 上海交通大學醫(yī)學院附屬瑞金醫(yī)院血液科聯(lián)合病房(徐匯區(qū)中心醫(yī)院);上海交通大學醫(yī)學院附屬瑞金醫(yī)院血液科;上海交通大學醫(yī)學院附屬瑞金醫(yī)院血液科聯(lián)合病房(北站醫(yī)院血液科);
【基金】：國家自然科學基金(81325003,81520108003,81670716,81201863) 上海市杰出青年醫(yī)學人才培養(yǎng)資助計劃 上海市教育委員會高峰高原學科建設計劃(20152206,20152208) 上海市科學技術委員會項目(14430723400,14140903100,16JC1405800) 靜安區(qū)衛(wèi)生科研課題(2016MS11) 徐匯區(qū)中心醫(yī)院院級科研課題(2014XHYY-04) 上海交通大學SMC-晨星青年學者獎勵計劃~~
【分類號】：R733.1

【參考文獻】

相關期刊論文 前3條

1 朱貴華;李秀梅;莊萬傳;江亞軍;何耀;柴星星;;沙利度胺聯(lián)合ICE方案治療復發(fā)性難治性非霍奇金淋巴瘤[J];現(xiàn)代腫瘤醫(yī)學;2014年07期

2 郝杰;李雪蓮;李良群;關爽;王黎;;MINE與ICE方案治療復發(fā)難治性淋巴瘤的療效比較[J];實用癌癥雜志;2012年01期

3 孫中義;易平勇;劉晰宇;周芳;歐陽周;賀軍僑;黃利軍;姚遠;;ICE方案和GemOX方案治療復發(fā)或難治性彌漫大B細胞淋巴瘤的臨床觀察[J];中國醫(yī)師雜志;2013年02期

【共引文獻】

相關期刊論文 前10條

1 鄭重;孫淵淵;夏O，

本文編號：2515983