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背景与目的:复发或耐药非霍奇金淋巴瘤(non鄄Hodgkin蒺slymphoma,NHL)目前尚无标准的解救化疗方案,DICE、ESHAP、MINE和EPOCH等常见的解救治疗方案缓解率仅为30%～70%。本文旨在观察DICE方案作为解救化疗方案治疗复发或耐药中高度恶性NHL的疗效和安全性。方法:选取35例复发或耐药的中高度恶性NHL患者,其中T细胞和B细胞NHL分别为14和21例,既往接受过以CHOP或CHOP样方案为主中位6周期(2～12个周期)的化疗,采用DICE方案进行解救治疗。结果:35例患者接受了中位4周期(2～7个周期)的DICE方案化疗,所有患者均可评价疗效和不良反应。总的客观有效率为74.3%,完全缓解率为31.4%;中位缓解时间为4个月(1～30个月),中位至治疗失败时间为7个月(2～34个月),中位生存期为14个月(3～51个月),实际2年生存率为33.3%。T细胞和B细胞NHL的有效率分别为85.7%(12/14)和66.7%(14/21),完全缓解率分别为50.0%(7/14)和19.0%(4/21)(P=0.073)。LDH升高和伴有巨大肿块是影响解救治疗疗效的高危因素(P<0.05),DICE解救疗效是复发耐药患者生存期的独立预后因素(P=0.001)。主要不良反应为骨髓抑制,Ⅲ～Ⅳ度粒细胞和血小板减少的发生率分别为71.4%和8.6%。结论:DICE方案是复发或耐药中高度恶性NHL安全有效的解救治疗方案。LDH升高和伴有巨大?
BACKGROUND & OBJECTIVE: There is no standard rescue regimen for recurrent or resistant non-Hodgkin’s lymphoma (NHL). The response rate of common rescue treatment programs such as DICE, ESHAP, MINE and EPOCH is only 30 % ~ 70%. This article aims to observe the efficacy and safety of DICE regimen as a rescue chemotherapy regimen in the treatment of recurrent or drug-resistant high-grade NHL. Methods: Thirty-five patients with recurrent or drug resistant NHL were selected. Among them, 14 and 21 NHL patients had T cell and B cell lymphoma, respectively. Previously, 6 patients (2 to 12 Cycle) of chemotherapy, the use of DICE program for rescue treatment. Results: 35 patients received median 4 cycles (2 to 7 cycles) of DICE regimen, and all patients were evaluated for efficacy and adverse reactions. The overall objective response rate was 74.3% and the complete remission rate was 31.4%. The median time to remission was 4 months (range 1 to 30 months), and the median time to treatment failure was 7 months (range 2 to 34 months) The median survival was 14 months (3 to 51 months), the actual 2-year survival rate was 33.3%. The effective rates of T lymphocyte and B cell NHL were 85.7% (12/14) and 66.7% (14/21) respectively, and the complete remission rates were 50.0% (7/14) and 19.0% (4/21), respectively (P = 0.073). Elevated LDH accompanied with huge lumps were the risk factors influencing the efficacy of rescue therapy (P <0.05). The rescue effect of DICE was an independent prognostic factor of survival in relapse-resistant patients (P = 0.001). The main adverse reaction was myelosuppression. The incidence of grade Ⅲ ~ Ⅳ granulocytes and thrombocytopenia were 71.4% and 8.6%, respectively. Conclusion: The DICE regimen is a safe and effective rescue and treatment regimen for relapsed or resistant middle and high-grade NHL. LDH increased and accompanied by huge?