摘要
目的:分析沙利度胺联合R-CHOP化疗方案(利妥昔单抗+环磷酰胺+多柔比星+长春新碱+醋酸泼尼松)治疗恶性淋巴瘤的临床疗效,并探讨其对患者肿瘤坏死因子-α(TNF-α)、血小板衍生生长因子(PDGF-BB)的影响。方法:采用便利抽样法,选取2017-10—2019-10我院收治的CD20阳性弥漫大B细胞淋巴瘤患者66例,按照弥漫大B细胞淋巴瘤的两种亚型分成2组,生发中心来源(GCB)组和非生发中心来源(non-GCB)组各33例,non-GCB组行单纯R-CHOP化疗方案,GCB组行沙利度胺联合R-CHOP化疗方案。比较2组临床效果、血清TNF-α及PDGF-BB水平变化、生活质量、生存率及不良反应。结果:治疗后,GCB组、non-GCB组总有效率分别为84.85%、66.67%,差异有统计学意义(P<0.05)。治疗后较治疗前2组TNF-α、PDGF-BB均明显下降,且GCB组明显低于non-GCB组(P<0.05)。GCB组生活质量总分为(73.11±10.41)分,明显高于non-GCB组的(57.61±11.33)分。GCB组恶心呕吐、食欲不振、经济困难明显低于non-GCB组,而便秘则高于non-GCB组,差异有统计学意义(P<0.05)。GCB组生存时间、生存率分别为(10.34±3.00)个月、39.39%,non-GCB组分别为(9.79±2.11)个月、27.27%,差异均无统计学意义(P>0.05)。GCB组、non-GCB组不良反应发生率分别为9.09%、24.24%,差异无统计学意义(P>0.05)。结论:沙利度胺联合R-CHOP化疗方案治疗CD20阳性弥漫大B细胞淋巴瘤的临床效果满意,能明显提高患者的生活质量,降低血清TNF-α、PDGF-BB水平,安全性高,具有一定的临床应用价值。
Objective:To analyze the clinical efficacy of thalidomide combined with R-CHOP chemotherapy(rituximab + cyclophosphamide + doxorubicin + vincristine + prednisone acetate) in the treatment of malignant lymphoma,and to explore the effect on tumor necrosis factor-α(TNF-α) and platelet-derived growth factor(PDGF-BB) in patients.Method:Sixty-six patients with CD20-positive diffuse large B-cell lymphoma treated in our hospital from October 2017 to October 2019 were selected by convenient sampling method.They were divided into two groups according to the random number table method,33 cases in the non-GCB group and 33 cases in the GCB group.Patients in the non-GCB group received a simple R-CHOP chemotherapy regimen,and patients in the GCB group received a thalidomide combined with R-CHOP chemotherapy regimen.The clinical effect,changes in serum TNF-α and PDGF-BB levels,quality of life,survival rate,and adverse events were compared between the two groups.Result:After treatment,the total effective rates in the GCB group and the non-GCB group were 84.85% and 66.67%,respectively,and the difference was statistically significant(P<0.05).After treatment,the levels of TNF-α and PDGF-BB in the two groups were significantly lower than those in the two groups before treatment,and the GCB group was significantly lower than the non-GCB group(P<0.05).The total quality of life in the GCB group was(73.11±10.41) points,which was significantly higher than that in the non-GCB group(57.61±11.33) points.The nausea and vomiting,loss of appetite,and economic difficulties were significantly lower in the GCB group than those in the non-GCB group,while constipation was higher than that in the non-GCB group,and the differences were statistically significant(P<0.05).The survival time and survival rate of the GCB group were(10.34±3.00)months and 39.39%,and the non-GCB group were(9.79±2.11)months and 27.27%,respectively,and the differences were not statistically significant(P>0.05).The rates of adverse events in the GCB group and the non-GCB group were 9.09% and 24.24%,respectively,and the difference was not statistically significant(P>0.05).Conclusion:Thalidomide combined with R-CHOP chemotherapy regimen has satisfactory clinical effect in the treatment of CD20 positive diffuse large B-cell lymphoma.It can significantly improve the quality of life in patients and reduce serum levels of TNF-αand PDGF-BB,with high safety and certain clinical application value.
作者
苏永宏
焦宁超
SU Yonghong;JIAO Ningchao(Department of Hematology,Shunyi District Hospital of Beijing,Beijing,101300,China;The Outpatient Department of Shunyi District Hospital of Beijing)
出处
《临床血液学杂志》
CAS
2020年第3期326-329,共4页
Journal of Clinical Hematology
