| 徐徐,陈恬,张敏,陈晨.R-CHOP方案治疗高危弥漫大B细胞淋巴瘤的疗效及安全性观察.[J].中南医学科学杂志.,2022,(2):268-271. |
| R-CHOP方案治疗高危弥漫大B细胞淋巴瘤的疗效及安全性观察 |
| Efficacy and safety of R-CHOP regimen in the treatment of high-risk diffuse large B-cell lymphoma |
| 投稿时间：2021-07-08 修订日期：2021-12-08 |
| DOI：10.15972/j.cnki.43-1509/r.2022.02.028 |
| 中文关键词: 弥漫大B细胞淋巴瘤 高危 R-CHOP方案 CHOP方案 免疫功能 β2-MG |
| 英文关键词:diffuse large B-cell lymphoma high-risk R-CHOP regimen CHOP regimen immune function β2-MG |
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| 中文摘要: |
| 目的分析利妥昔单抗、环磷酰胺、阿霉素、长春新碱、泼尼松(R-CHOP)方案治疗高危弥漫大B细胞淋巴瘤(DLBCL)的疗效及安全性。方法回顾性分析102例高危DLBCL患者临床资料,其中行R-CHOP方案者56例(R-CHOP组),行CHOP方案者46例(CHOP组)。记录两组临床疗效及不良事件发生情况,评估治疗前、后外周血T细胞亚群(CD4＋、CD8＋)、B淋巴细胞亚群(CD20＋)、血清免疫球蛋白M(IgM)及IgG、β2-微球蛋白(β2-MG)变化情况。结果R-CHOP组临床疗效明显高于CHOP组(P＜0.05)。与治疗前比较,R-CHOP组治疗后CD4＋、IgM、IgG均降低,CD8＋均升高,随疗程延长差异更显著；且治疗4、6个疗程R-CHOP组较同时间CHOP组更显著(P＜0.05)。与治疗前比较,R-CHOP组治疗后CD20＋均显著降低,且均低于同时间CHOP组(P＜0.05)。与治疗前比较,两组治疗后β2-MG均降低,随疗程延长差异更显著；且治疗4、6个疗程R-CHOP组较同时间CHOP组更低(P＜0.05)。经Spearman秩相关分析发现,R-CHOP组临床疗效与治疗4个疗程、6个疗程后β2-MG水平呈显著负相关(P＜0.05)。结论R-CHOP方案对高危DLBCL近期疗效显著,安全性良好,但能影响患者免疫功能,血清β2-MG水平对监测疗效有利。 |
| 英文摘要: |
| To analyze the efficacy and safety of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) regimen in the treatment of high-risk diffuse large B-cell lymphoma (DLBCL). MethodsThe clinical data of 102 patients with high-risk DLBCL in the hospital were retrospectively analyzed, including 56 patients treated with R-CHOP regimen(R-CHOP group) and 46 patients treated with CHOP regimen (CHOP group). The clinical efficacy and occurrence of adverse events were recorded in the two groups, and the changes in peripheral blood T cell subsets (CD4＋, CD8＋), B lymphocyte subset (CD20＋), serum immunoglobulin M (IgM) and IgG and β2-microglobulin (β2-MG) were evaluated before and after treatment. ResultsThe clinical efficacy in R-CHOP group was significantly higher than that in CHOP group (P＜0.05). Peripheral blood CD4＋, IgM and IgG after treatment in R-CHOP group were decreased while CD8＋ was increased compared to before treatment, and the differences were more significant with the extension of treatment course. In addition, the differences in the above indicators in R-CHOP group after 4 courses of treatment and 6 courses of treatment were more significant than those in CHOP group (P＜0.05). Peripheral blood CD20＋ in R-CHOP group was significantly reduced after treatment compared with that before treatment, and was lower than that in CHOP group (P＜0.05). The level of serum β2-MG after treatment in the two groups was declined compared to before treatment, and the difference was more obvious with the extension of course. After 4 courses and 6 courses of treatment, the level of serum β2-MG in R-CHOP group was lower than that in CHOP group (P＜0.05). Spearman rank correlation analysis showed that the clinical efficacy in R-CHOP group was significantly negatively correlated with serum β2-MG level after 4 courses and 6 courses of treatment (P＜0.05). ConclusionR-CHOP regimen has significant short-term efficacy and high safety on high-risk DLBCL, but it can affect the immune function of patients. Serum β2-MG level is beneficial to monitoring the efficacy. |
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