利妥昔單抗聯合CHOP方案治療初治B細胞非霍奇金淋巴瘤的療效觀察

[摘要] 目的 探討利妥昔單抗聯合CHOP治療初治B細胞非霍奇金淋巴瘤（NHL）的近期療效和毒副反應。 方法 65例初治B細胞NHL隨機分為兩組，觀察組35例接受利妥昔單抗聯合CHOP方案治療，對照組30例僅接受CHOP方案化療，并比較觀察兩組的近期療效和毒副反應。 結果 觀察組總有效率及臨床獲益率分別為71.43%、94.29%，均高于對照組的50.00%、70.00%，差異有統計學意義（P均<0.05）。觀察組出現3例利妥昔單抗相關的輕度發熱。兩組化療相關毒副反應均較輕，且發生率比較差異均無統計學意義（P均>0.05）。所有毒副反應均未影響治療的順利進行。 結論 利妥昔單抗聯合CHOP方案治療初治B細胞NHL療效較單純CHOP方案好，但毒副反應未增加，值得臨床推廣應用。

[關鍵詞] 非霍奇金淋巴瘤；利妥昔單抗；CHOP方案；CD20

[中圖分類號] R733.4 [文獻標識碼] B [文章編號] 2095-0616（2013）13-40-03

Rituximab combined with CHOP regimen in the treatment of the initial patients with B-cell non-Hodgkin lymphoma

LI Jun SU Yongqiang LIU Yingjie

Department of Oncology，the 152th Hospital of PLA，Pingdingshan 467000，China

[Abstract] Objective To investigate the short term efficacy and toxicities of rituximab combined with CHOP regimen in the treatment of the initial patients with B-cell non-Hodgkin lymphoma （NHL）. Methods Sixty-five initial patients with B-cell NHL were randomly divided into two groups，35 patients of the observation group were treated with rituximab combined with CHOP regimen，30 patients of the control group were treated with only CHOP chemotherapy，and the efficacy and toxicities were compared. Results The total response rate and the clinical benefit rate were 71.43% and 94.29%，and were 50.00% and 70.00% in the control group （P<0.05）. The rituximab-related mild fever was observed in the 3 patients. The toxicities related to chemotherapy were mild in the two groups，there was no statistical differences in the incidences between the two groups （P>0.05）. Conclusion Rituximab combined with CHOP regimen has better efficacy in the treatment of the patients with B-cell NHL，but the toxicities doesn't increased.

[Key words] Non-Hodgkin lymphoma；Rituximab；CHOP program；CD20

非霍奇金淋巴瘤（non-Hodgkin lymphoma，NHL）是一種常見的來源于淋巴系統惡性腫瘤，大多數來源于B細胞，且95%以上的B細胞性淋巴瘤陽性表達CD20，臨床上針對該特點研發了針對CD20抗原陽性淋巴瘤的免疫制劑抗CD20單克隆抗體利妥昔單抗，并取得了較好的臨床療效[1]。CHOP方案是治療NHL的標準治療方案。本研究采用利妥昔單抗聯合CHOP方案治療CD20陽性的B細胞NHL患者，并單純采用CHOP方案作為對照，比較觀察兩者的療效，現報道如下。

1 資料與方法

1.1 一般資料

2008年1月～2011年12月我院收治的初治NHL患者65例，均經病理學檢查確診為B細胞NHL，且CD20陽性。其中男35例，女30例；年齡18～65歲，平均（44.5±7.3）歲；臨床分期：臨床Ann arbor分期：Ⅰ期13例，Ⅱ期30例，Ⅲ期22例；彌漫性大B細胞性53例，濾泡細胞性8例，套細胞性2例，間變大B細胞性2例。……