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吉西他滨、长春瑞滨、脂质体多柔比星(GVD)14 天方案作为挽救方案治疗既往大量治疗的霍奇金淋巴瘤和侵袭性非霍奇金淋巴瘤患者具有良好的长期疗效。

Promising long-term outcome of gemcitabine, vinorelbine, liposomal doxorubicin (GVD) in 14-day schedule as salvage regimen for patients with previously heavily treated Hodgkin's lymphoma and aggressive non-Hodgkin's lymphoma.

机构信息

Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou 510060, Guangdong, People's Republic of China.

出版信息

Med Oncol. 2013 Mar;30(1):350. doi: 10.1007/s12032-012-0350-5. Epub 2013 Jan 18.

Abstract

The combination of gemcitabine (G), vinorelbine (V), and pegylated liposomal doxorubicin (D) has proved to be effective in relapsed Hodgkin's lymphoma (HL). Its efficacy in non-Hodgkin's lymphoma (NHL) remains to be discussed. We retrospectively evaluated the efficacy and toxicity of the dose-adjusted gemcitabine, vinorelbine, liposomal doxorubicin (GVD) in 14-day schedule in 35 heavily pretreated patients with relapsed and refractory aggressive NHL or HL. Treatment consisted of G: 800 mg/m(2) intravenous (i.v.) on day 1, V: 15 mg/m(2) i.v. on day 1; D: 20 mg/m(2) i.v. on day 1, repeated for 14 days. Patients responded to GVD proceeded to subsequent autologous stem cell transplantation. The objective response rate (ORR) was 48.6 %, with 31.4 % complete remission. A higher ORR was observed in patients with HL than in patients with NHL (80.0 vs. 36.0 %, P = 0.023). With a median follow-up of 26 months, the estimated median progression-free survival and overall survival were 5 (range 1-73 months) and 36 months (range 2-73 months), respectively. The estimated 5-year survival rate was 44.6 % (95 % confidence interval 28.1-61.1 %). Toxicities were mild (grade 3/4 neutropenia 34.3 %, thrombocytopenia 5.7 %). Our results suggest that the dose-adjusted GVD in 14-day schedule is effective and well tolerated in patients with refractory and relapsed HL and aggressive NHL. The potential long-term survival in NHL is promising.

摘要

吉西他滨(G)、长春瑞滨(V)和聚乙二醇脂质体阿霉素(D)联合应用已被证明在复发的霍奇金淋巴瘤(HL)中有效。其在非霍奇金淋巴瘤(NHL)中的疗效仍有待讨论。我们回顾性评估了剂量调整的吉西他滨、长春瑞滨、脂质体阿霉素(GVD)在 14 天方案中的疗效和毒性,共 35 例复发和难治性侵袭性 NHL 或 HL 患者接受了治疗。治疗方案为:G 800 mg/m(2) 静脉滴注(i.v.),第 1 天;V 15 mg/m(2) i.v.,第 1 天;D 20 mg/m(2) i.v.,第 1 天,每 14 天重复一次。对 GVD 有反应的患者继续进行后续自体干细胞移植。客观缓解率(ORR)为 48.6%,完全缓解率为 31.4%。HL 患者的 ORR 高于 NHL 患者(80.0%比 36.0%,P = 0.023)。中位随访 26 个月时,估计的中位无进展生存期和总生存期分别为 5(1-73 个月)和 36 个月(2-73 个月)。估计的 5 年生存率为 44.6%(95%置信区间 28.1-61.1%)。毒性反应较轻(3/4 级中性粒细胞减少症 34.3%,血小板减少症 5.7%)。我们的结果表明,在难治性和复发性 HL 以及侵袭性 NHL 患者中,14 天方案的剂量调整 GVD 是有效且耐受良好的。NHL 的潜在长期生存率是有希望的。

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