Dumontet C, Bastion Y, Felman P, Ffrench M, Blanc M, Peaud P Y, Bryon P A, Coiffier B
Service d'hématologie, Centre hospitalier Lyon-Sud, Pierre-Bénite, France.
Bull Cancer. 1992;79(10):979-89.
The 100 patients with aggressive malignant non Hodgkin lymphoma treated with the LNH-80 regimen were evaluated for long-term survival and quality of life. 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 patients 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. Factors adversely correlated with response in multivariate analysis were poor performance status, bone marrow involvement and the presence of more than one extranodal site. Factors adversely correlated with survival were age, high grade subtypes, and bone marrow involvement. The fifty-two long-term responders were evaluated for quality of life parameters such as working ability, sexual function, fertility and absence of long-term sequelae. Of the 41 patients who worked before disease, 66% had resumed their normal job 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%) considered having 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 a second neoplasia. The LNH-80 regimen allowed 52% of the patients to benefit from long-term disease-free survival with minor long-term toxicity.
对采用LNH - 80方案治疗的100例侵袭性恶性非霍奇金淋巴瘤患者进行了长期生存和生活质量评估。LNH - 80方案包括三个阿霉素、环磷酰胺、长春地辛和博来霉素强化疗程，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例患者持续完全缓解存活，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年时仍观察到晚期复发。多因素分析中与缓解不良相关的因素是体能状态差、骨髓受累以及存在一个以上结外部位。与生存不良相关的因素是年龄、高级别亚型和骨髓受累。对52例长期缓解者进行了生活质量参数评估，如工作能力、性功能、生育能力和无长期后遗症情况。在疾病发生前工作的41例患者中，66%已恢复正常工作，24%已退休。66%的患者认为性功能令人满意。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%）认为有轻度长期后遗症，但所有长期幸存者均报告生活质量可接受。达到CR的患者中有5例（6%）发生了第二种肿瘤。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。
