Wang Quan-Shun, Zhao Yu, Wang Shu-Hong, Li Hong-Hua, Huang Wen-Rong, Gao Chun-Ji, Yu Li
Department of Hematology, Chinese PLA General Hospital, Beijing 100853, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2011 Jun;19(3):676-9.
This study was purposed to investigate the changes of serum immunoglobulin (Ig) level during treatment of diffuse large B cell lymphoma by using rituximab (RTX) combined with CHOP. Total of 122 newly diagnosed patients with CD20(+) diffuse large B cell lymphoma from January 2004 to December 2009 were analyzed retrospectively. According to different treatment regimens, 122 patients were divided into 2 group: group treated with CHOP (n = 24) and group treated with R-CHOP (n = 98, out of which 16 patients with abnormal Ig levels before treatment). Ig levels of patients in 2 groups at different stages were recorded and analyzed after abandoning those patients with abnormal Ig levels before treatment. The results showed that after 6 cycles of treatment, among the total 82 patients with normal levels of serum immunoglobulin, the decreased levels of IgG, IgA and IgM by 20% of baseline value were found in 85.4% (70/82), 85.4% (70/82) and 87.8% (72/82) patients respectively, while levels of IgG, IgA and IgM < low limit of normal value were observed in 47.6% (39/82), 48.8% (40/82) and 52.4% (43/82) patients respectively. No obvious changes of IgG, IgA and IgM levels were found in 24 patients of CHOP group before and after treatment.It is concluded that hypogammaglobulinemia is a common complication in chemotherapy using RTX combined with CHOP, the decreased level of Ig is recovered to normal level about 1 year after stop of treatment, the decrease of Ig in some cases can last even for over 2 years.
本研究旨在探讨利妥昔单抗（RTX）联合CHOP方案治疗弥漫性大B细胞淋巴瘤过程中血清免疫球蛋白（Ig）水平的变化。回顾性分析2004年1月至2009年12月期间122例新诊断的CD20（+）弥漫性大B细胞淋巴瘤患者。根据不同治疗方案，将122例患者分为2组：CHOP方案治疗组（n = 24）和R-CHOP方案治疗组（n = 98，其中16例患者治疗前Ig水平异常）。剔除治疗前Ig水平异常的患者后，记录并分析两组患者不同阶段的Ig水平。结果显示，治疗6个周期后，在血清免疫球蛋白水平正常的82例患者中，IgG、IgA和IgM水平较基线值下降20%的患者分别占85.4%（70/82）、85.4%（70/82）和87.8%（72/82），而IgG、IgA和IgM水平低于正常值下限的患者分别占47.6%（39/82）、48.8%（40/82）和52.4%（43/82）。CHOP方案治疗组的24例患者治疗前后IgG、IgA和IgM水平无明显变化。结论：低丙种球蛋白血症是RTX联合CHOP化疗的常见并发症，Ig水平下降在停药后约1年恢复正常，部分患者Ig水平下降可持续2年以上。
