氟达拉滨和环磷酰胺联合利妥昔单抗治疗慢性淋巴细胞白血病疗效分析
불체랍빈화배린선알연합리타석단항치료만성림파세포백혈병료효분석
Efficacy of combination chemoimmunotherapy of fludarabine, cyclophosphamide and rituximab for chronic lymphocytic leukemia
  • 万方数据
    中华血液学杂志 중화혈액학잡지
    Chinese Journal of Hematology
    2011年 1期 3-7 ,共5页

    方成%徐卫%徐敏%洪鸣%朱丹霞%朱华渊%吴雨洁%范磊%乔纯%庄芸%缪扣荣%刘澎%李建勇

    방성%서위%서민%홍명%주단하%주화연%오우길%범뢰%교순%장예%무구영%류팽%리건용

    白血病,淋巴细胞,慢性%氟达拉滨%环磷酰胺%利妥昔单抗%治疗结果 白血病,淋巴細胞,慢性%氟達拉濱%環燐酰胺%利妥昔單抗%治療結果
    백혈병,림파세포,만성%불체랍빈%배린선알%리타석단항%치료결과
    Leukemia,lymphocytic,chronic%Fludarabine%Cyclophosphamide%Rituximab
    目的 探讨氟达拉滨和环磷酰胺联合利妥昔单抗(FCR方案)治疗慢性淋巴细胞白血病(CLL)的效果.方法 采用FCR方案治疗21例CLL患者,其中10例为初治患者,11例为复治患者.FCR方案为氟达拉滨25 mg/m2,第2～4天,静脉滴注;环磷酰胺250 mg/m2,第2～4天,静脉滴注;利妥昔单抗375 mg/m2,第1天,静脉滴注.每28 d为1个疗程.采用多参数流式细胞术(FCM)检测微量残留病(MRD).同时对治疗前临床特点与完全缓解(CR)率行相关性分析.结果 11例(52.4%)患者获得CR,7例(33.3%)获得部分缓解,总有效率为85.7%;中位随访时间19(7～73)个月,总生存率为86.0%,无进展生存率为72.0%.单变量分析表明治疗前Binet分期为A+B、免疫球蛋白重链可变区基因有突变或ZAP-70阳性细胞率≤20%与高CR率相关;6例患者化疗后MRD低于1%.FCR方案的不良反应主要表现为骨髓抑制和胃肠道反应.结论 FCR方案对CLL的治疗有确切疗效.
    목적 탐토불체랍빈화배린선알연합리타석단항(FCR방안)치료만성림파세포백혈병(CLL)적효과.방법 채용FCR방안치료21례CLL환자,기중10례위초치환자,11례위복치환자.FCR방안위불체랍빈25 mg/m2,제2～4천,정맥적주;배린선알250 mg/m2,제2～4천,정맥적주;리타석단항375 mg/m2,제1천,정맥적주.매28 d위1개료정.채용다삼수류식세포술(FCM)검측미량잔류병(MRD).동시대치료전림상특점여완전완해(CR)솔행상관성분석.결과 11례(52.4%)환자획득CR,7례(33.3%)획득부분완해,총유효솔위85.7%;중위수방시간19(7～73)개월,총생존솔위86.0%,무진전생존솔위72.0%.단변량분석표명치료전Binet분기위A+B、면역구단백중련가변구기인유돌변혹ZAP-70양성세포솔≤20%여고CR솔상관;6례환자화료후MRD저우1%.FCR방안적불량반응주요표현위골수억제화위장도반응.결론 FCR방안대CLL적치료유학절료효.
    Objective To evaluate the efficacy of combination chemoimmunotherapy of fludarabine,cyclophosphamide and rituximab (FCR) in chronic lymphocytic leukemia (CLL). Methods Twenty-one patients with CLL were treated with FCR regimen which consisted of fludarabine (25 mg/m2, days 2 to 4),cyclophosphamide (250 mg/m2, days 2 to 4) and rituximab ( 375 mg/m2, day 1 ) in a course of 28 days.The minimal residual disease (MRD) was determined by multiparameter flow cytometry. The correlation between the pretreatment characteristics and complete remission (CR) rate was analyzed. Results Eleven patients (52.4%) achieved CR, 7 (33.3%) achieved partial remission (PR) with a overall response (OR)rate of 85.7%. With a median follow-up time of 19 (7 -73 ) months, the overall survival (OS) was 86.0%,and the progression-free survival (PFS) was 72.0%. Pretreatment parameters independently associated with higher CR rates were Binet stage A + B, IgVH mutated and ZAP-70 less than 20%. MRD was less than 1% in 6 patients. The most common toxicities were myelosuppression and gastrointestinal reaction. Conclusion FCR is an effective regimen for CLL patients.
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