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一项回顾性队列研究描述了接受 EPOCH±R 治疗的非霍奇金淋巴瘤患者的化疗引起的周围神经病:HIV 状况是否重要?

A retrospective cohort study describing chemotherapy-induced peripheral neuropathy in Non-Hodgkin lymphoma patients treated with EPOCH ± R: does HIV status matter?

机构信息

The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.

Data Coordination and Analysis Center, College of Optometry, The Ohio State University, Columbus, OH, USA.

出版信息

Leuk Lymphoma. 2024 Aug;65(8):1110-1116. doi: 10.1080/10428194.2024.2340051. Epub 2024 Apr 22.

Abstract

The frontline immuno-chemotherapy regimen for HIV-associated non-Hodgkin Lymphoma is dose-adjusted EPOCH ± R (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab). Chemotherapy-induced peripheral neuropathy (CIPN), caused by vincristine, is a common adverse effect of EPOCH ± R, negatively impacting long-term patient outcomes. The primary objective of this study was to determine the incidence of CIPN, stratified by HIV status, in patients treated with EPOCH ± R. A retrospective cohort study at a tertiary referral comprehensive cancer center evaluated patients treated with EPOCH ± R from 2011 to 2018. The final sample included 27 patients with HIV compared to 279 without HIV (total  = 306). Overall, the incidence of CIPN was 29.4% ( = 90), including 5 with HIV (18.5%) and 85 without HIV (30.5%). Propensity scores were used to match patients by HIV status. Although no relationship was found between HIV status and neuropathy, CIPN affects too many undergoing treatments for lymphoma, supporting future investigations to minimize toxicities.

摘要

用于 HIV 相关非霍奇金淋巴瘤的一线免疫化疗方案是剂量调整 EPOCH ± R(依托泊苷、泼尼松、长春新碱、环磷酰胺、多柔比星和利妥昔单抗)。长春新碱引起的化疗引起的周围神经病变(CIPN)是 EPOCH ± R 的常见不良反应,对长期患者结局产生负面影响。本研究的主要目的是确定接受 EPOCH ± R 治疗的患者中按 HIV 状态分层的 CIPN 发生率。在一家三级转诊综合癌症中心进行的回顾性队列研究评估了 2011 年至 2018 年接受 EPOCH ± R 治疗的患者。最终样本包括 27 例 HIV 患者和 279 例无 HIV 患者(总计 306 例)。总体而言,CIPN 的发生率为 29.4%(90 例),其中 5 例 HIV 患者(18.5%)和 85 例无 HIV 患者(30.5%)。使用倾向评分按 HIV 状态匹配患者。尽管未发现 HIV 状态与神经病变之间存在关系,但 CIPN 影响了太多接受淋巴瘤治疗的患者,支持未来的研究以最大程度地减少毒性。

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