原发耐药弥漫大B细胞淋巴瘤36例临床分析
Clinical Analysis of 36 Cases with Primary Refractory Diffuse Large B Cell Lymphoma
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摘要: 目的 分析原发耐药弥漫大B细胞淋巴瘤的临床特征和治疗方法,探讨患者的疗效和主要预后影响因素。 方法 对广东省人民医院淋巴瘤科2006年3月至2014年12月收治的36例原发耐药弥漫大B细胞淋巴瘤患者的临床特点、治疗方案、疗效及预后进行回顾性分析。 结果 36例原发耐药弥漫大B细胞淋巴瘤患者中,一线治疗方案均为阿霉素为主的化疗方案 ± 利妥昔单抗,5例患者未接受挽救治疗,二线治疗方案有DICE、GDP、DHAP、CEPP、来那度胺以及GA101,接受治疗患者的中位无进展生存时间（距首次复发）为1.7个月,2年无进展生存率为5.0%,中位总生存时间（距首次复发）为7.9个月,2年总生存率为25.9%。单因素分析显示复发时国际预后指数高、大病灶、B症状对患者生存率有影响,差异有统计学意义。仅有3名患者获得>30个月的长期生存,2名患者均使用新的靶向药物。 结论 原发耐药弥漫大B细胞淋巴瘤患者预后差,难以从常规挽救化疗中得到获益。Abstract: Objective To investigate the survival ratio and factors affecting prognosis by analyzing clinical data. Methods Clinical data of 36 cases with primary refractory diffuse large B cell lymphoma admitted to Guangdong General Hospital were retrospectively analyzed. Results 5 patients refused further salvage treatment. First-line chemotherapy are anthracycline-based regimens combined with or without rituximab. The salvage treatment regimens are DICE, GDP, DHAP, CEPP, Lenalidomide and GA101. Median second progression free survival time is 1.7 months with 2 year second progression free survival rate being 5.0%. Median second overall survival time is 7.9 months with 2 year second overall survival rate being 25.9%. Univariate analyses showed that high IPI, bulky disease and B symptom influenced the prognosis. Conclusions Patients with primary refractory diffuse large B cell lymphoma have poor prognosis and can't benefit from regular salvage chemotherapy.
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