【摘要】：目的探討利妥昔單抗在慢性淋巴細胞白血病(CLL)患者中的療效。方法回顧性分析本院一線應(yīng)用氟達拉濱+環(huán)磷酰胺±利妥昔單抗方案或環(huán)磷酰胺+長春新堿+潑尼松±蒽環(huán)類藥物±利妥昔單抗方案治療的CLL患者病例資料,比較利妥昔單抗及不同化療方案的療效。結(jié)果一線采用含利妥昔單抗方案治療的患者為72例(43.6%);不含利妥昔單抗方案治療的患者為93例(56.4%)。利妥昔單抗治療組完全緩解(CR)率和總體反應(yīng)率(ORR)均顯著高于未應(yīng)用利妥昔單抗治療組(38.9%比21.5%,P=0.015;83.3%比60.2%,P=0.001)。利妥昔單抗治療組中位無進展生存期(PFS)為53.0(27.0~79.0)個月,中位總生存時間(OS)為112.0(81.1~142.9)個月,而未應(yīng)用利妥昔單抗治療組中位PFS為28.0(18.3~37.7)個月(P=0.094),中位OS為89.0(72.0~106.0)個月(P=0.109),兩組比較差異無統(tǒng)計學(xué)意義。按是否伴有高危遺傳學(xué)因素(伴17p缺失或11q缺失)將患者分成高危組和非高危組,高危組聯(lián)合利妥昔單抗治療患者可顯著提高ORR(86.4%比53.3%,P=0.012),但PFS[14.5(7.9~21.1)個月比20.5(10.7~30.3)個月,P=0.699]及OS[96.0(55.3~136.7)個月比74.0(48.0~100.0)個月,P=0.366]無優(yōu)勢;而在非高危組中,應(yīng)用利妥昔單抗后患者PFS有延長趨勢[71.0(55.3~86.7)個月比38.5(17.7~59.3)個月],但差異無統(tǒng)計學(xué)意義(P=0.050)。結(jié)論 CLL患者應(yīng)用利妥昔單抗聯(lián)合化療可獲得更高的CR率、ORR,并對不伴染色體17p缺失或11q缺失患者的PFS有改善趨勢。
[Abstract]:Objective to investigate the efficacy of rituximab in patients with chronic lymphoblastic leukemia (CLL). Methods the data of CLL patients treated with fludarabine cyclophosphamide + rituximab regimen or cyclophosphamide vincristine prednisone + anthracycline 鹵rituximab regimen were analyzed retrospectively. the therapeutic effects of rituximab and different chemotherapy regimens were compared. Results 72 patients (43.6%) were treated with rituximab regimen and 93 patients (56.4%) without rituximab regimen. The complete remission rate and total response rate of (ORR) in rituximab group were significantly higher than those in non-rituximab treatment group (38.9% vs 21.5%, P 鈮，

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