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[侵袭性非霍奇金淋巴瘤的化疗:单机构回顾性分析]

[Chemotherapy of aggressive non-Hodgkin's lymphomas: a retrospective analysis of a single institution].

作者信息

Ohnoshi T, Hayashi K, Ueno K, Murashima M, Tada A, Mizuta J, Tagawa S, Kimura I, Motoi M

出版信息

Rinsho Ketsueki. 1989 Aug;30(8):1201-4.

PMID:2601033
Abstract

In order to assess the curability of diffuse non-Hodgkin's lymphoma, a total of 93 patients who had entered into protocol studies in our institution was analysed retrospectively. Between 1977 and 1988, 53 large cell lymphoma (DL), 16 mixed cell lymphoma (DMx), and 24 medium-sized cell lymphoma (DM) patients with advanced disease were treated with CHOP, CHOP-Bleo, or CHOP-Bleo alternating with POEM-Bleo (5-drug combination of mitoxantrone, etoposide, vincristine, bleomycin, and prednisolone). The complete response rate was 70% for DL, 69% for DMx, and 54% for DM. The response was most durable in DL, compared with DMx and DM: the relapse-free survival rate at 5-year was 71% for DL, both 38% for DMx and DM. Almost all the relapses had occurred within 2 years in DL, DMx and DM, as well, thus responding patients over 2 years after cessation of chemotherapy appeared to have been cured. Relapse-free survival rate was almost the same for T- and B-lymphoma, however, the 5-year survival rate of T-lymphoma was lower than that of B-lymphoma, reflecting the poor complete response rate of the former. Finally, the disease-free survival rate at 5-year was 39% for all the 93 patients, with a trend favoring for DL histology with a rate of 51%. The alternating CHOP-Bleo/POEM-Bleo regimen appears beneficial compared with conventional regimens such as CHOP and CHOP-Bleo on the basis of response rate and response durability, and these results warrant further clinical trials.

摘要

为评估弥漫性非霍奇金淋巴瘤的可治愈性,我们对在本机构参与方案研究的93例患者进行了回顾性分析。1977年至1988年期间,53例大细胞淋巴瘤(DL)、16例混合细胞淋巴瘤(DMx)和24例中细胞淋巴瘤(DM)的晚期患者接受了CHOP、CHOP - 博来霉素或CHOP - 博来霉素与POEM - 博来霉素交替方案(米托蒽醌、依托泊苷、长春新碱、博来霉素和泼尼松龙的5药联合方案)治疗。DL的完全缓解率为70%,DMx为69%,DM为54%。与DMx和DM相比,DL的缓解持续时间最长:DL的5年无复发生存率为71%,DMx和DM均为38%。DL、DMx和DM几乎所有复发均发生在2年内,因此化疗停止后超过2年仍有反应的患者似乎已治愈。T细胞淋巴瘤和B细胞淋巴瘤的无复发生存率几乎相同,然而,T细胞淋巴瘤的5年生存率低于B细胞淋巴瘤,这反映了前者较差的完全缓解率。最后,93例患者的5年无病生存率为39%,DL组织学类型的患者有51%,有更高的趋势。基于缓解率和缓解持续时间,与CHOP和CHOP - 博来霉素等传统方案相比,CHOP - 博来霉素/POEM - 博来霉素交替方案似乎更有益,这些结果值得进一步进行临床试验。

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