摘要
目的评价氟达拉滨联合环磷酰胺（FC）化疗方案治疗小淋巴细胞淋巴瘤/慢性淋巴细胞白血病（SLL/CLL）的疗效和不良反应。方法21例SLL/CLL患者,其中初发者11例,复发、难治者10例,均接受FC化疗方案：氟达拉滨25～30 mg.m^-2静脉滴注,第1～3天,环磷酰胺400～600 mg.m^-2静脉滴注,第1天。21 d为1个周期,重复6个周期。结果21例平均完成约4.4个周期,完全缓解（CR）率61.9%（13/21）,部分缓解（PR）率28.6%（6/21）,总有效（OR）率90.5%（19/21）;其中初发组CR率63.6%（7/11）,PR率36.4%（4/11）,OR率100%（11/11）;复发难治组CR率60.0%（6/10）,PR率20.0%（2/10）,OR率80.0%（8/10）,2组CR率、OR率无显著性差异（P〉0.05）。主要不良反应为骨髓抑制和免疫功能抑制,出现Ⅲ～Ⅳ级白细胞减少7例（33.3%）,出现Ⅲ～Ⅳ级血小板减少4例（19.1%）,出现感染、发热7例（33.3%）,无相关毒性死亡。其他毒性反应包括恶心、呕吐、轻度肝肾功能损坏、自身免疫性溶血性贫血。2 a生存率为90.5%（19/21）,2 a无病生存率为80.9%（17/21）,其中初发组2 a生存率100%（11/11）,2 a无病生存率100%（11/11）;复发难治组2 a生存率90.0%（9/10）,2 a无病生存率70.0%（7/10）,2组间2 a生存率和无病生存率无显著性差异（P〉0.05）。结论氟达拉滨联合环磷酰胺对SLL/CLL的近期疗效较好,患者能够耐受其毒副作用,但是远期疗效有待进一步观察。
Objective To evaluate the therapeutic effect and adverse reaction of fludarabine and eyelophosphamide for treatment of patients with small lymphotie lymphoma/ chronic lymphocytic leukemia （SLL/CLL）. Methods Twenty-one patients with SLL/CLL（ eleven patients of whom wrere previously untreated and ten of whom were relapsed/refractory） were treated with FC regiment ：fludarabine 25 -30 mg · m^-2 ,intravenously guttae,from the first day to the third day,and eyelophosphamide 400 -600 mg· m^-2 ,intravenously guttae,the first day,21 days was a treatment cycle and repeated for 6 cycles. Results The average course of twenty-one patients were 4.4. The rate of complete respose （CR）,partial response（PR） and overall response （OR） was 61.9% （ 13/21 ）,28.6% （ 6/21 ） and 90.5% （ 19/21 ） respectively. There were no significant difference in the rate of CR,PR and OR between previously untreated and relapsed/refractory group （63.6% ,36.4% , 100% vs 60% ,20.0% ,80.0% respetively,P 〉 0. 05 ）. The main adverse reactions included myelosuppression and immunosupression. Grade Ⅲ-Ⅳ leukopenia was found in seven （33.3%） patients,and grade Ⅲ-Ⅳ thromboeytopenia in four（ 19.1% ） patients. Infection and fever occurred in seven（33.3% ）patients,but no patient died for that. Other toxicities mainly included nausea vomiting and mild liver, kidney function impairment and autoimmune haemolytie anemia. The median follow-up time was 24 months （ rang 1 - 40 months）. 2 year survival rate was 90.5% （ 19/21 ） and 2 year progression free survival rate was 80.9% （ 17/21 ）. 2 year survival rate and progression free survival rate were 100% （ 11/11 ） in the previously untreated group. While in the relapsed/refractory group,2 year survival rate and progression free survival rate were 80.0% （8/10）and 60.0% （6/10） respectively. There was no significant difference between the two groups （ P 〉 0.05 ）. Conclusion The FC combined chemotherapty regiment on patients with SLL/CLL had a good therapeutic effect and few adverse reaetion,but more attention should be given to the long-term effeet.
出处
《新乡医学院学报》
CAS
2008年第6期588-590,共3页
Journal of Xinxiang Medical University
