论文部分内容阅读
目的:探讨利妥昔单抗与化疗相结合治疗弥漫型大B细胞淋巴瘤(diffuse large Bcelllymphoma,DLBCL)患者的可行性。方法:选取2002年1月至2011年5月我院收治的84例CD20阳性的DLBCL患者,采用利利妥昔单抗与化疗相结合的方法治疗,对其疗效及安全性进行评价,并对其影响因素进行分析。结果:有56例患者治疗艹6个周期,占66.67%;有28例患者治疗<6个周期,占33.33%。84例患者治疗的总有效率为83.33%。其中,初治组的总有效率为91.67%,明显高于复治组的62.5%,差异有统计学意义(P<0.05)。红细胞沉降率、国际预后指数评分、是否为初治、是否存在B症状以及利妥昔单抗的治疗周期等变量成为影响治疗效果的独立危险因素(P<0.05)。随访5年,治疗后第l年、2年、3年和5年患者的生存率分别为88.1%(74/84)、72.62%(61/84)、60.71%(51/84)、60.71%(51/84)。国际预后指数评分、利妥昔单抗的治疗周期以及治疗效果等变量是影响患者生存的独立危险因素(P<0.05)。结论:对于弥漫型大B细胞淋巴瘤患者尤其是对初治患者而言,利妥昔单抗联合化疗治疗具有更好的治疗效果,临床应用时不会加重患者的不良反应。
Objective: To investigate the feasibility of rituximab combined with chemotherapy in the treatment of patients with diffuse large B cell lymphoma (DLBCL). Methods: From January 2002 to May 2011, 84 patients with CD20-positive DLBCL admitted to our hospital were selected and treated with combination therapy of Rituximab and chemotherapy to evaluate their efficacy and safety. Its influencing factors are analyzed. Results: There were 56 patients treated for 6 cycles, accounting for 66.67%; 28 patients treated for 6 cycles accounting for 33.33%. The total effective rate of 84 patients was 83.33%. Among them, the total effective rate of the newly diagnosed group was 91.67%, which was significantly higher than that of the retreatment group (62.5%), the difference was statistically significant (P <0.05). Erythrocyte sedimentation rate, international prognostic index score, whether initial treatment, the presence of B symptoms and the treatment cycle of rituximab were independent risk factors (P <0.05). The 5-year follow-up was 88.1% (74/84), 72.62% (61/84), 60.71% (51/84) and 60.71% at the first year, the second year, the third year and the fifth year after treatment, (51/84). The international prognostic index score, treatment cycle of rituximab, and treatment effect variables were independent risk factors affecting the survival of patients (P <0.05). Conclusion: Rituximab combined with chemotherapy has better therapeutic effect on patients with diffuse large B-cell lymphoma, especially for newly diagnosed patients, and will not aggravate adverse reactions in clinical practice.