CAJ | 학술논문

HBsAg阴性HBcAb阳性弥漫大B细胞淋巴瘤患者CHOP与R-CHOP方案化疗的肝功能损害分析
HBsAg음성HBcAb양성미만대B세포림파류환자CHOP여R-CHOP방안화료적간공능손해분석
Comparative analysis of liver function in HBsAg -/HBcAb + patients with diffuse large B-cell lymphoma treated with CHOP and R-CHOP regimens

万方数据

中华肿瘤杂志中華腫瘤雜誌 중화종류잡지
CHINESE JOURNAL OF ONCOLOGY
2012年 5期 385-389 ,共5页

黄燕华%何小慧%秦燕%杨晟%吕铮%董梅%周生余%刘鹏%张长弓%杨建良%石远凯

황연화%하소혜%진연%양성%려쟁%동매%주생여%류붕%장장궁%양건량%석원개

淋巴瘤%HBsAg%HBcAb%利妥昔单抗淋巴瘤%HBsAg%HBcAb%利妥昔單抗
림파류%HBsAg%HBcAb%리타석단항
Lymphoma%HBsAg%HBcAb%Rituximab

目的分析既往感染乙型肝炎病毒(HBV)的HBsAg(-)HBcAb(+)弥漫大B细胞淋巴瘤(DLBCL)患者在接受CHOP和R-CHOP方案化疗后的肝功能耐受情况.方法 2005年1月至2008年12月收治的86例HBsAg(-)HBcAb(+)DLBCL患者,其中CHOP方案组47例,R-CHOP 方案组39例,均未给予抗乙肝病毒治疗,比较两组患者各周期化疗后及化疗结束后1年内肝功能损害程度.结果 CHOP方案组和R-CHOP方案组在第5个周期化疗后,肝功能损害发生率分别为28.6％和6.2％,差异有统计学意义(P=0.026)；而在第1、2、3、4、6个周期化疗后,肝功能损害发生率差异均无统计学意义(均P＞0.05).CHOP方案组和R-CHOP方案组的大部分患者中在不同化疗周期时肝功能正常,均未见Ⅳ度肝功能损害.CHOP方案组和R-CHOP方案组患者在化疗结束后1 ～3个月肝功能正常者分别占 60.0％和68.0％,4～6个月占92.3％和75.0％,7～9个月占90.0％和81.8％,10 ～ 12个月占92.3％和92.9％,差异均无统计学意义(均P＞0.05).结论 HBsAg(-)HbcAb(+)的DLBCL患者接受CHOP方案或R-CHOP方案化疗时,肝功能损害发生率均很低,且利妥昔单抗的应用也并未增加患者肝功能损害的发生率,因此本研究不支持常规预防性抗乙肝病毒治疗,但治疗期间应密切监测患者的肝功能、乙肝标志物及HBV-DNA水平.
목적 분석기왕감염을형간염병독(HBV)적HBsAg(-)HBcAb(+)미만대B세포림파류(DLBCL)환자재접수CHOP화R-CHOP방안화료후적간공능내수정황.방법 2005년1월지2008년12월수치적86례HBsAg(-)HBcAb(+)DLBCL환자,기중CHOP방안조47례,R-CHOP 방안조39례,균미급여항을간병독치료,비교량조환자각주기화료후급화료결속후1년내간공능손해정도.결과 CHOP방안조화R-CHOP방안조재제5개주기화료후,간공능손해발생솔분별위28.6％화6.2％,차이유통계학의의(P=0.026)；이재제1、2、3、4、6개주기화료후,간공능손해발생솔차이균무통계학의의(균P＞0.05).CHOP방안조화R-CHOP방안조적대부분환자중재불동화료 주기시간공능정상,균미견Ⅳ도간공능손해.CHOP방안조화R-CHOP방안조환자재화료결속후1 ～3개월간공능정상자분별점 60.0％화68.0％,4～6개월점92.3％화75.0％,7～9개월점90.0％화81.8％,10 ～ 12개월점92.3％화92.9％,차이균무통계학의의(균P＞0.05).결론 HBsAg(-)HbcAb(+)적DLBCL환자접수CHOP방안혹R-CHOP방안화료시,간공능손해발생솔균흔저,차리타석단항적응용야병미증가환자간공능손해적발생솔,인차본연구불지지상규예방성항을간병독치료,단치료기간응밀절감측환자적간공능、을간표지물급HBV-DNA수평.
Objective To analyze the liver function in patients with diffuse large B-cell lymphoma (DLBCL),who are hepatitis B surface antigen negative/antibody to hepatitis B core antigen positive ( HBsAg -/HBcAb + ),treated with CHOP and R-CHOP regimens.Methods In this retrospective study,86 DLBCL patients,who were HBsAg -/HBcAb +,were collected from Cancer Hospital of Chinese Academy of Medical Sciences between January 2005 and December 2008.The patients were given at least two cycles of chemotherapy using CHOP-like or R-CHOP-like regimen without anti-HBV treatment,and followed--up for at least 12 months after completion of therapy.Results Forty-seven patients received CHOP-like regimen while 39 patients received R-CHOP-like regimen.There were no significant differences in the degree of liver dysfunction between CHOP group and R-CHOP group after the 1st,2nd,3rd,4th and 6th cycles(22.7％ -46.7％ with CHOP and 17.6％ -34.2％ with R-CHOP,respectively,( all P ＞ 0.05 ),except for the 5th cycles( 28.6％ vs.6.2％,P =0.026).Liver function in most patients in CHOP group and R-CHOP group was normad after every cycle (53.3％-77.3％ and 65.8％-93.8％,respectively ).Meanwhile,there were no significant differences in the degree of liver dysfunction between CHOP group and R-CHOP group in the 1st-3rd month,4th-6th month,7th-9th month and 10th-12th month after completion of therapy(7.7％-40.0％ with CHOP and 7.4％-32.0％ with R-CHOP,respectively,all P ＞0.05).Conclusions The present study reveals a low incidence of liver dysfunction in HBsAg -/HBcAb + DLBCL patients,both in CHOP group and in R-CHOP group.It may indicate a potential low incidence of HBV reactivation in these groups,and Rituximab do not increase the rate of liver dysfunction.Therefore,these data may not support regularly prophylactic antiviral therapy during chemotherapy,but close monitoring of liver function,HBV serum markers and HBV DNA level are demanded.