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阿糖胞苷、卡铂和类固醇联合挽救化疗用于复发或难治性非霍奇金淋巴瘤

[Salvage combination chemotherapy with cytarabine, carboplatin and steroids for relapsed or refractory non-Hodgkin's lymphoma].

作者信息

Yamamura Ryousuke, Yamane Takahisa, Aoyama Yasutaka, Nakamae Hirohisa, Hasegawa Tarou, Ohta Kensuke, Nakao Yoshitaka, Ohta Tadanobu, Mugitani Atsuko, Hino Masayuki

机构信息

Dept. of Clinical Hematology and Clinical Diagnostics, Graduate School of Medicine, Osaka City University.

出版信息

Gan To Kagaku Ryoho. 2004 Mar;31(3):373-5.

Abstract

We have treated 29 patients (19 men and 10 women) with relapsed or refractory non-Hodgkin's lymphoma with a combination of cytarabine (Ara-C), carboplatin (CBDCA) and prednisolone (PSL). The regimen, on days 1 to 3, included Ara-C, 400 mg/m2 i.v.; CBDCA; 250 mg/m2 i.v.; and PSL, 40 mg/m2. Since complete response was achieved in 10 patients (34.5%) and partial response in 9 (31.0%), the total response rate was 65.5%. The 50% survival duration of all patients after the initiation of this therapy was 8 months. The overall 5-year survival rate was 66.7% for those who achieved CR or PR with the Ara-C/CBDCA regimen and received high-dose chemotherapy and autologous hematopoietic stem cell transplantation. Myelosuppression was the major toxicity. Total WBC counts under 1,000/microliter were seen in 67.7% of the courses, and thrombocytopenia under 50,000/microliter was seen in 96.8%. Ara-C/CBDCA has proven to be an effective salvage regimen for patients with relapsed or refractory lymphoma. High-dose chemotherapy and autologous hematopoietic stem cell transplantation should be considered for salvageable patients.

摘要

我们采用阿糖胞苷(Ara-C)、卡铂(CBDCA)和泼尼松龙(PSL)联合方案治疗了29例复发或难治性非霍奇金淋巴瘤患者(19例男性和10例女性)。该方案在第1至3天包括静脉注射阿糖胞苷400mg/m²、静脉注射卡铂250mg/m²和口服泼尼松龙40mg/m²。10例患者(34.5%)达到完全缓解,9例(31.0%)达到部分缓解,总缓解率为65.5%。所有患者开始该治疗后的50%生存持续时间为8个月。对于采用阿糖胞苷/卡铂方案达到完全缓解或部分缓解并接受大剂量化疗和自体造血干细胞移植的患者,总体5年生存率为66.7%。骨髓抑制是主要毒性反应。67.7%的疗程出现白细胞总数低于1000/微升,96.8%出现血小板减少低于50000/微升。阿糖胞苷/卡铂已被证明是复发或难治性淋巴瘤患者有效的挽救方案。对于可挽救的患者应考虑大剂量化疗和自体造血干细胞移植。

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