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采用LNH - 80方案治疗侵袭性淋巴瘤患者的长期预后及后遗症

Long-term outcome and sequelae in aggressive lymphoma patients treated with the LNH-80 regimen.

作者信息

Dumontet C, Bastion Y, Felman P, Ffrench M, Blanc M, Peaud P Y, Coiffier B

机构信息

Service d'Hématologie, Centre Hospitalier Lyon-Sud, Pierre Bénite, France.

出版信息

Ann Oncol. 1992 Sep;3(8):639-44. doi: 10.1093/oxfordjournals.annonc.a058293.

Abstract

One hundred patients with aggressive malignant lymphoma treated with the LNH-80 regimen were evaluated for long-term survival, late relapse and long-term sequelae. The LNH-80 regimen consisted of three intensive courses of adriamycin, cyclophosphamide, vindesine and bleomycin, followed by consolidation and final intensification, as previously described. Of the eighty-four patients who achieved CR after induction, fifty-two are alive in continuous complete remission with a median follow-up of 9.2 years. Twenty-nine CR patients (35%) relapsed. Sixty-six percent of the relapses occurred during the first 18 months following the end of treatment but late relapses were observed up to 7 years off-therapy. The fifty-two long-term responders were evaluated for their ability to resume work, sexual function, fertility and presence of long-term sequelae. Of the 41 patients who worked before diagnosis of their disease, 66% had resumed their normal jobs and 24% had retired. Sexual activity was considered to be satisfactory by 66% of the patients. Eleven of the 15 patients (73%) who wanted children had between one and three children. Seven patients (14%) were considered to have mild long-term sequelae but all long-term survivors reported having an acceptable quality of life. Five of the patients who reached CR (6%) had second neoplasias. The LNH-80 regimen allowed 52% of the patients to benefit from long-term disease-free survival with minor long-term toxicity.

摘要

对采用LNH - 80方案治疗的100例侵袭性恶性淋巴瘤患者进行了长期生存、晚期复发和长期后遗症评估。LNH - 80方案包括三个密集疗程的阿霉素、环磷酰胺、长春地辛和博来霉素,随后进行巩固和最终强化,如前所述。诱导治疗后达到完全缓解(CR)的84例患者中,52例持续完全缓解存活,中位随访时间为9.2年。29例CR患者(35%)复发。66%的复发发生在治疗结束后的前18个月,但在停止治疗长达7年时也观察到晚期复发。对52例长期缓解者的恢复工作能力、性功能、生育能力和长期后遗症情况进行了评估。在疾病诊断前工作的41例患者中,66%已恢复正常工作,24%已退休。66%的患者认为性活动令人满意。15例想要孩子的患者中有11例(73%)育有1至3个孩子。7例患者(14%)被认为有轻度长期后遗症,但所有长期存活者均报告生活质量尚可。达到CR的患者中有5例(6%)发生了第二肿瘤。LNH - 80方案使52%的患者受益于长期无病生存,且长期毒性较小。

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