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地塞米松、奥沙利铂和阿糖胞苷(R-DHAOx)作为挽救和干细胞动员疗法在复发/难治性弥漫性大 B 细胞淋巴瘤中的应用。

Dexamethasone, oxaliplatin and cytarabine (R-DHAOx) as salvage and stem cells mobilizing therapy in relapsed/refractory diffuse large B cell lymphomas.

机构信息

Clinic of Hematology, Department of Internal Medicine (DiMI), University of Genoa, Genoa, Italy.

Ospedale Policlinico San Martino IRCCS, Genoa, Italy.

出版信息

Leuk Lymphoma. 2020 Jan;61(1):84-90. doi: 10.1080/10428194.2019.1658102. Epub 2019 Sep 4.

Abstract

Cisplatin-containing salvage regimens followed by autologous hematopoietic stem cell (HSC) transplantation are the current standard of care for relapsed or refractory (R/R) lymphomas. We retrospectively analyzed efficacy and stem cell mobilizing activity of oxaliplatin, cytarabine, dexamethasone and rituximab (R-DHAOx) in 53 R/R diffuse large B cell lymphomas (DLBCL) treated in our center (median lines 2, range 2-5; median age 59, range 22-79). Hematological toxicity was manageable and no patients experienced renal impairment. After 2 courses the overall response rate was 60% (CR 49%, PR 11%). Median overall survival (OS) was 30.53 months (95% CI 11.5-49.55), 3-year OS 40.5%. Twenty-two eligible patients collected HSC and transplantation was performed in 21/22 patients (95%), after a median of 52 days from last cycle. Our results suggest that in DLBCL R-DHAOx has an excellent stem cell mobilizing capability, response rate comparable to cisplatin-containing regimens and good toxicity profile.

摘要

奥沙利铂、阿糖胞苷、地塞米松和利妥昔单抗(R-DHAOx)联合方案用于挽救治疗复发/难治性(R/R)弥漫性大 B 细胞淋巴瘤(DLBCL),我们对在本中心接受该方案治疗的 53 例 R/R DLBCL 患者的疗效和干细胞动员活性进行了回顾性分析(中位治疗线数 2,范围 2-5;中位年龄 59 岁,范围 22-79 岁)。血液学毒性可控制,无患者发生肾功能损害。2 个疗程后,总体缓解率为 60%(完全缓解率 49%,部分缓解率 11%)。中位总生存期(OS)为 30.53 个月(95%CI 11.5-49.55),3 年 OS 为 40.5%。22 例符合条件的患者采集了造血干细胞,21/22 例(95%)患者在最后一个疗程后中位 52 天进行了移植。我们的研究结果表明,在 DLBCL 中,R-DHAOx 具有极好的干细胞动员能力,缓解率与含顺铂方案相当,且毒性谱良好。

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