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目的探讨CEOP方案联合大剂量甲氨喋呤治疗有中枢复发倾向的侵袭性淋巴瘤的临床疗效。方法7例有中枢复发倾向的侵袭性淋巴瘤均接受CEOP方案联合大剂量甲氨喋呤(3.0 g·m-2,静脉滴注6h,第10天)化疗。结果 7例患者中,6例可评价疗效,均达到完全缓解。主要毒副反应为骨髓抑制(其中Ⅲ、Ⅳ度粒细胞减少发生率为41%)和谷丙转氨酶升高(44%),非血液学毒性少而轻,6疗程因粒细胞减少甲氨蝶呤给药延迟至第15天,无治疗相关性死亡发生。结论 CEOP方案联合大剂量甲氨喋呤治疗侵袭性淋巴瘤近期疗效较好,可作为有中枢复发倾向的侵袭性淋巴瘤的治疗方案,治疗过程中应当注意骨髓抑制和谷丙转氨酶升高的防治。
Objective To investigate the clinical efficacy of CEOP combined with high-dose methotrexate in the treatment of invasive lymphoma with a central tendency of recurrence. Methods Seven cases of aggressive lymphoma with central tendency of recurrence were treated with CEOP regimen combined with high dose methotrexate (3.0 g · m-2, intravenous infusion 6h, day 10). Results Of the 7 patients, 6 patients could evaluate the curative effect, all achieved complete remission. The main toxicities were myelosuppression (III and IV degree neutropenia was 41%) and alanine aminotransferase elevation (44%), non-hematologic toxicities less and less, 6 courses of neutropenia Methotrexate The administration of dexamethasone was delayed until day 15 and no treatment-related death occurred. Conclusion CEOP combined with high-dose methotrexate in the treatment of aggressive lymphoma has a good curative effect in the near future, which can be used as a treatment for invasive lymphoma with central tendency of recurrence. In the course of treatment, we should pay attention to the prevention and treatment of myelosuppression and elevated alanine aminotransferase .