Yalçin S, Kars A, Ozişik Y, Tekuzman G, Ozyilkan O, Celik I, Barişta I, Güllü I, Güler N, Baltali E, Firat D
Hacettepe University Institute of Oncology Ankara, Turkey.
Eur J Haematol. 1998 Oct;61(4):261-5. doi: 10.1111/j.1600-0609.1998.tb01712.x.
Despite intensive search for the optimal combination chemotherapy for aggressive non-Hodgkin's lymphoma (NHL), the CHOP (cyclophosphamide, adriamycin, vincristine and prednisolone) regimen is still the standard therapy. We investigated the clinical efficacy of a new combination regimen consisting of vincristine, bleomycin-cyclophosphamide, adriamycin, etoposide and prednisolone (VB-CHEP) in patients with aggressive NHL. A total of 29 patients with aggressive NHL was enrolled into the protocol. Eight patients were consolidated with cisplatin and cytarabine and 5 patients received radiotherapy for bulky disease. Objective response was achieved in 82.8% of the patients. Complete remission (CR) and partial remission rates were 72.4%, and 10.3%, respectively. CR rate was significantly lower in patients with advanced stage, extranodal disease and bone marrow involvement. Median follow-up time is 34+ months; 17 patients are disease-free while 12 died and only 2 patients with CR have relapsed so far. Median response duration is 29+ months and the median survival is 48+ months. The survival rate is 69% in the first year and 66% in the second year. A total of 152 cycles were evaluated for toxicity. Major hematological toxicity was myelosuppression and neutropenia, detected in 50.65%, was mostly grades 1-2. Neutropenic fever occurred in only 11 cycles. The side effects of the consolidation therapy were also acceptable. We conclude that the VB-CHEP regimen with consolidation therapy for high-risk patients may be an effective treatment for advanced stage aggressive NHL.
尽管人们一直在深入探寻侵袭性非霍奇金淋巴瘤（NHL）的最佳联合化疗方案，但CHOP（环磷酰胺、阿霉素、长春新碱和泼尼松龙）方案仍是标准治疗方法。我们研究了一种由长春新碱、博来霉素 - 环磷酰胺、阿霉素、依托泊苷和泼尼松龙组成的新联合方案（VB - CHEP）对侵袭性NHL患者的临床疗效。共有29例侵袭性NHL患者纳入该方案。8例患者接受顺铂和阿糖胞苷巩固治疗，5例患者因病灶较大接受放疗。82.8%的患者获得客观缓解。完全缓解（CR）率和部分缓解率分别为72.4%和10.3%。晚期、结外病变和骨髓受累患者的CR率显著较低。中位随访时间为34 +个月；17例患者无疾病，12例死亡，目前只有2例CR患者复发。中位缓解持续时间为29 +个月，中位生存期为48 +个月。第一年生存率为69%，第二年为66%。共评估了152个周期的毒性。主要血液学毒性为骨髓抑制和中性粒细胞减少，发生率为50.65%，大多为1 - 2级。仅11个周期出现中性粒细胞减少性发热。巩固治疗的副作用也可接受。我们得出结论，对于高危患者采用VB - CHEP方案并进行巩固治疗可能是晚期侵袭性NHL的一种有效治疗方法。
