摘要
目的:探索西达本胺联合化疗和单独化疗治疗外周T细胞淋巴瘤的疗效及预后因素分析。方法:收集诊断为外周T细胞淋巴瘤(包括AITL、PTCL-NOS、ALCL亚型)的临床资料完整的38例患者,16例接受西达本胺联合化疗治疗,22例接受单纯化疗治疗,观察并比较2组患者的疗效及预后因素分析。结果:联合治疗组中6例获得完全缓解(CR),5例获得部分缓解(PR),有效率为68.8%,中位总生存(OS)时间为30(2~41)个月,中位无进展生存(PFS)时间为26个月;单纯化疗组中5例获得CR,1例获得PR,有效率为27.3%,中位OS时间为14(2~25)个月,中位PFS时间为12个月;2组治疗方案的疗效差异有统计学意义(P<0.05)。通过进一步对不同亚型的疗效比较发现,联合治疗组中AITL的有效率显著高于单纯化疗组(66.7%∶11.1%,P=0.023),而2组PTCL-NOS和ALCL亚型的有效率差异无统计学意义(均P>0.05)。联合治疗组中血液学、胃肠道反应、乏力及感染的不良反应较单纯化疗组严重(P<0.05)。Log-rank检验单因素分析显示,Ann Arbor分期、伴随B症状、骨髓受累、IPI评分、乳酸脱氢酶是PTCL的预后影响因素,而性别、年龄、起病部位、β2-微球蛋白则与生存时间无明显关系。Cox回归多因素生存分析结果显示,乳酸脱氢酶正常者预后好于升高者。结论:西达本胺联合化疗治疗外周T细胞淋巴瘤近期及远期临床疗效均较单纯化疗组好。联合治疗组血液学、胃肠道反应、乏力及感染的不良反应较单纯化疗组重,但患者可以耐受,且无患者因不良反应而发生死亡。
Objective：To explore the efficacy and prognostic factors of chidamide combined with chemotherapy or chemotherapy alone in the treatment of peripheral T-cell lymphoma.Method：Thirty eight peripheral T-cell lymphoma patients（including AITL,PTCL-NOS,ALCL subtype）were enrolled,and 16 cases treated with chidamide combined with chemotherapy and 22 cases treated with chemotherapy alone.We observed and compared the efficacy and adverse events of the two groups.Result：In the combined treatment group,6 cases received CR,5 cases received PR and the RR was 68.8%.The median OS time and the median PFS time was 30（2 to 41）months and 26 months in the combined treatment group.In the chemotherapy group,5 cases received CR,1 case received PR and the RR was 27.3%.The median OS time and the median PFS time was 14（2 to 25）months and 12 months in the chemotherapy group.There was significant difference in efficacy between the 2 groups（P〈0.05）.The RR of AITL in the combined group was higher than that in the chemotherapy group（66.7% vs 11.1%,P=0.023）.There was no significant differences in RR between PTCL-NOS and ALCL subgroups（P〉0.05）.There were significant differences in the adverse events of hematology,gastrointestinal reactions,fatigue and infection between the 2 groups（P〈0.05）.Log-rank test single factor analysis showed that Ann Arbor stage,with B symptoms,bone marrow involvement,IPI score and LDH were prognostic factors of PTCL.While gender,age,location of onset,beta2-microglobulin had no obvious relationship with survival time.Cox regression multivariate survival analysis showed patients with normal LDH were better than those with increased LDH.Conclusion：Chidamide combined with chemotherapy in the treatment of peripheral T-cell lymphoma has better clinical efficacy in long and short term than chemotherapy alone.The adverse events of hematology,gastrointestinal,fatigue and infection in the combined group are severer than those in the chemotherapy group.However,the patients can tolerate and no patients die due to the adverse events.
作者
付金月
王树叶
FU Jinyue;WANG Shuye(Department of Hematology,the First Affiliated Hospital of Harbin Medical University,Harbin,150001,China)
出处
《临床血液学杂志》
CAS
2018年第4期531-534,共4页
Journal of Clinical Hematology
基金
国家重点基础研究发展计划子课题(No:2012CBA01303)
