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ESHAP与IEV化疗方案治疗复发或难治性霍奇金淋巴瘤和非霍奇金淋巴瘤的疗效比较

ESHAP versus IEV Chemotherapy for Relapsed or Refractory Hodgkin's and Non-Hodgkin's Lymphoma.

作者信息

Dehghani Mehdi, Vojdani Reza, Khalafi-Nezhad Abolfazl, Ravanbod Mohammad Reza, Ramzi Mani, Dehdashti Shima, Taherifard Erfan, Namdari Nasrin

机构信息

Department of Hematology and Medical Oncology, Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Department of Hematology and Medical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Int J Hematol Oncol Stem Cell Res. 2025 Apr 1;19(2):151-157. doi: 10.18502/ijhoscr.v19i2.18552.

Abstract

High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard treatment for Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL) in cases of relapsed or refractory disease. Various salvage chemotherapy regimens have been introduced with specific response rates, toxicity profiles, costs, and stem cell damage before stem cell harvest. The optimal salvage regimen for these patients is unclear. In this retrospective analysis, 276 patients with HL and NHL with relapsed or refractory disease after initial treatment that received ESHAP (etoposide, methylprednisolone, cytosine arabinoside, and platinum) or IEV (ifosfamide, epirubicin, etoposide) as salvage regimen were included. We aimed to compare the efficacy of these two chemotherapy regimens as a life-saving treatment in recurrent or refractory disease. The mean age of patients was 33.96 ± 12.39 years. Hodgkin's lymphoma accounted for 60.1% and non-Hodgkin lymphoma (DLBCL) accounted for 39.9% of patients. The overall response rate (ORR) was 79.8% (50% complete response (CR)) for patients with Hodgkin lymphoma who received the ESHAP and 85.6% (55.1% CR) for the IEV regimen. Patients with non-Hodgkin's lymphoma who received the ESHAP plus rituximab regimen had an ORR of 60.9% (CR 40.3%), and patients who received the IEV + Rituximab chemotherapy regimen had an ORR of 72.4% (CR 42.4%) (P = 0.03). However, the mortality rate was lower in patients who received the IEV chemotherapy regimen. IEV treatment is superior to ESHAP in patients with recurrent or refractory Hodgkin's and non-Hodgkin's lymphoma.

摘要

大剂量化疗后进行自体干细胞移植(ASCT)是复发或难治性霍奇金淋巴瘤(HL)和非霍奇金淋巴瘤(NHL)的标准治疗方法。已经引入了各种挽救性化疗方案,这些方案具有特定的缓解率、毒性特征、成本以及干细胞采集前的干细胞损伤情况。这些患者的最佳挽救方案尚不清楚。在这项回顾性分析中,纳入了276例初始治疗后复发或难治的HL和NHL患者,他们接受了ESHAP(依托泊苷、甲泼尼龙、阿糖胞苷和铂)或IEV(异环磷酰胺、表柔比星、依托泊苷)作为挽救方案。我们旨在比较这两种化疗方案作为复发性或难治性疾病挽救治疗的疗效。患者的平均年龄为33.96±12.39岁。霍奇金淋巴瘤占患者的60.1%,非霍奇金淋巴瘤(弥漫大B细胞淋巴瘤)占39.9%。接受ESHAP方案的霍奇金淋巴瘤患者的总缓解率(ORR)为79.8%(完全缓解(CR)率为50%),接受IEV方案的为85.6%(CR率为55.1%)。接受ESHAP加利妥昔单抗方案的非霍奇金淋巴瘤患者的ORR为60.9%(CR率为40.3%),接受IEV + 利妥昔单抗化疗方案的患者的ORR为72.4%(CR率为42.4%)(P = 0.03)。然而,接受IEV化疗方案的患者死亡率较低。对于复发性或难治性霍奇金淋巴瘤和非霍奇金淋巴瘤患者,IEV治疗优于ESHAP。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebe1/12368709/33e5745d3cec/IJHOSCR-19-151-g001.jpg

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