摘要
目的:探讨MYC及Bcl2和/或Bcl6双表达的弥漫性大B细胞淋巴瘤(DLBCL)患者疗效及对患者生存的影响。方法:回顾性分析初治36例双表达(DEL)及非双表达(non-DEL)DLBCL患者临床资料,分析两组患者临床特征的差异。所有患者采取常规CHOP方案[环磷酰胺(CTX)750mg/m2,d1;盐酸表柔比星(EPI)60mg/m2,第1天;长春新碱(VCR)1.4mg/m2(最大2mg),d1;泼尼松60mg/m2,d1~5,21d/周期)]化疗或者免疫化疗(利妥昔单克隆抗体375mg/m2,d0,其余用药同常规化疗方案)。所有患者至少接受3个疗程以上化疗,中位疗程数5个(3~8个)。观察其疗效,并分析比较DEL及non-DEL患者的生存差异。结果:DEL患者5年OS显著优于non-DEL患者,差异有统计学意义(P<0.05)。结论:DEL-DLBCL患者一线R-CHOP方案治疗有效,但总体预后较差,对疗效不佳或者复发/难治的患者可考虑含新药,如来那度胺的方案一线治疗或者挽救治疗。
Objective:To investigate the efficacy and survival of diffuse large B-cell lymphoma(DLBCL)patients with double expression of MYC and Bcl2 and/or Bcl6(DEL). Methods:The data of 36 patients with del and non-del-DLBCL were retrospectively analyzed,and the differences of clinical characteristics between the two groups were analyzed.All patients were treated with CHOP +/-rituximab for 6~8 courses,and the curative effects of the two groups were compared.The survival differences between the two groups were analyzed and compared.Results:The 5-year OS of DEL patients was significantly better than that of non-DEL patients.Results:No difference of efficacy was observed between DEL and non-DEL groups. 5-year-OS of DEL group was significantly higher than non-DEL group, but there was no difference upon considering PFS.Result:The 5-year OS of DEL patients was significantly better than that of non-DEL patients,the difference was statistically significant(P<0.05). Conclusions:The first-line R-CHOP regimen of DEL-DLBCL is effective,but the overall prognosis is poor.For patients with poor efficacy or relapse/refractory treatment,first-line or salvage treatment with new drugs such as lenalidomide may be considered.
作者
史玉叶
陶红
李蕴劼
史文婷
卢雪莹
王春玲
于亮
Shi Yuye;Tao Hong;Li Yunjie;Shi Wenting;Lu Xueying;Wang Chunling;Yu Liang(Department of Hematology,Huai'an First Hospital Affiliated to Nanjing Medical University,Jiangsu Huaian 223300)
出处
《中国社区医师》
2019年第28期18-19,21,共3页
Chinese Community Doctors
基金
江苏省卫生健康委员会科研资助项目(H2018085)~~
作者简介
通信作者:于亮.
