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目的探讨GNP(吉西他滨+奈达铂+甲泼尼松龙)联合方案治疗复发或难治性非霍奇金淋巴瘤的临床疗效。方法经GNP方案治疗的39例复发或难治性非霍奇金淋巴瘤患者,其中复发性非霍奇金淋巴瘤18例,难治性21例,分别治疗2~6个周期,观察临床疗效、不良反应发生情况及1a总生存和无进展生存情况。结果 39例患者中完全缓解9例,部分缓解19例,稳定8例,进展3例,客观有效率为71.8%,临床获益率为92.3%;23例T细胞淋巴瘤客观有效率为60.9%,16例B细胞淋巴瘤客观有效率为87.5%;患者1a总生存率为87.2%,无进展生存时间10.4个月(95%CI:5.3~13.8);不良反应以轻度血液学不良反应为主,Ⅲ~Ⅳ度白细胞计数减少发生率为41.0%,贫血发生率为35.9%,血小板减少发生率为25.6%;Ⅰ~Ⅱ度消化道反应发生率为38.5%,肝功能损害发生率为15.4%。结论 GNP联合方案治疗复发或难治性非霍奇金淋巴瘤可提高缓解率和无进展生存期,不良反应较轻。
Objective To investigate the clinical efficacy of GNP (gemcitabine + nedaplatin + methylprednisolone) in the treatment of relapsed or refractory non-Hodgkin’s lymphoma. Methods Ninety-nine patients with recurrent or refractory non-Hodgkin’s lymphoma treated by GNP regimen, including 18 recurrent non-Hodgkin’s lymphoma and 21 refractory, were treated for 2 to 6 cycles respectively, and the clinical efficacy was observed , The occurrence of adverse reactions and 1a overall survival and progression-free survival. Results Of the 39 patients, 9 were completely relieved, 19 were partially relieved, 8 were stable, 3 were progressive. The objective effective rate was 71.8% and the clinical benefit rate was 92.3%. The objective effective rate of 23 T-cell lymphoma was 60.9% , 16 cases of B-cell lymphoma objective efficiency was 87.5%; patient 1a overall survival rate was 87.2%, progression-free survival time 10.4 months (95% CI: 5.3 ~ 13.8); adverse reactions with mild hematological adverse reactions as The prevalence of grade Ⅲ ~ Ⅳ leukocyte count was 41.0%, anemia was 35.9% and thrombocytopenia was 25.6%. The incidence of Ⅰ ~ Ⅱ degree digestive tract reaction was 38.5% and the incidence of hepatic dysfunction was 15.4 %. Conclusions GNP regimen in the treatment of relapsed or refractory non-Hodgkin’s lymphoma can improve the remission rate and progression-free survival with mild adverse reactions.