中国肿瘤临床
中國腫瘤臨床
중국종류림상
CHINESE JOURNAL OF CLINICAL ONCOLOGY
2015年
1期
13-18
,共6页
史幼梧%石远凯%秦燕%刘鹏%桂琳%周生余%杨建良%何小慧%张长弓%杨晟%韩晓红%孙燕
史幼梧%石遠凱%秦燕%劉鵬%桂琳%週生餘%楊建良%何小慧%張長弓%楊晟%韓曉紅%孫燕
사유오%석원개%진연%류붕%계림%주생여%양건량%하소혜%장장궁%양성%한효홍%손연
淋巴母细胞淋巴瘤%HyperCVAD方案%高剂量治疗%自体造血干细胞移植
淋巴母細胞淋巴瘤%HyperCVAD方案%高劑量治療%自體造血榦細胞移植
림파모세포림파류%HyperCVAD방안%고제량치료%자체조혈간세포이식
lymphoblastic lymphoma%HyperCVAD regimen%high-dose therapy%autologous hematopoietic stem cell transplantation
目的：探讨单纯Hyper-CVAD方案与Hyper-CVAD方案联合自体造血干细胞移植一线巩固治疗淋巴母细胞淋巴瘤（lymphoblastic lymphoma，LL）的疗效。方法：回顾性分析26例青少年和成人初治采用改良Hyper-CVAD方案的LL患者资料。其中，22例不伴骨髓受侵的患者中，11例接受单纯改良Hyper-CVAD方案治疗，另外11例接受改良Hyper-CVAD方案联合HDT/AH?SCT巩固治疗。结果：全组61.5%（16/26）的患者初治达完全缓解（complete remission，CR）或不确定的CR（unconfirmed CR，CRu），中位随访29.5个月，5年的总生存（overall survival，OS）率和无进展生存（progress-free survival，PFS）率分别为66.8%和50.2%。22例无骨髓受侵的患者中，单纯Hyper-CVAD组与联合HDT/AHSCT组的5年OS率分别为60.0%和70.7%（P=0.438），5年PFS率分别为43.6%和62.3%（P=0.209），均无统计学差异。单因素预后分析结果显示，初治缓解后1年内疾病进展或复发与预后不良相关（P=0.012）。结论：改良Hyper-CVAD方案是青少年和成人LL一线有效的治疗方案。对于无骨髓侵犯的患者，单纯改良Hyper?CVAD已能取得较好疗效，联合HDT/AHSCT巩固治疗未能进一步改善预后。
目的：探討單純Hyper-CVAD方案與Hyper-CVAD方案聯閤自體造血榦細胞移植一線鞏固治療淋巴母細胞淋巴瘤（lymphoblastic lymphoma，LL）的療效。方法：迴顧性分析26例青少年和成人初治採用改良Hyper-CVAD方案的LL患者資料。其中，22例不伴骨髓受侵的患者中，11例接受單純改良Hyper-CVAD方案治療，另外11例接受改良Hyper-CVAD方案聯閤HDT/AH?SCT鞏固治療。結果：全組61.5%（16/26）的患者初治達完全緩解（complete remission，CR）或不確定的CR（unconfirmed CR，CRu），中位隨訪29.5箇月，5年的總生存（overall survival，OS）率和無進展生存（progress-free survival，PFS）率分彆為66.8%和50.2%。22例無骨髓受侵的患者中，單純Hyper-CVAD組與聯閤HDT/AHSCT組的5年OS率分彆為60.0%和70.7%（P=0.438），5年PFS率分彆為43.6%和62.3%（P=0.209），均無統計學差異。單因素預後分析結果顯示，初治緩解後1年內疾病進展或複髮與預後不良相關（P=0.012）。結論：改良Hyper-CVAD方案是青少年和成人LL一線有效的治療方案。對于無骨髓侵犯的患者，單純改良Hyper?CVAD已能取得較好療效，聯閤HDT/AHSCT鞏固治療未能進一步改善預後。
목적：탐토단순Hyper-CVAD방안여Hyper-CVAD방안연합자체조혈간세포이식일선공고치료림파모세포림파류（lymphoblastic lymphoma，LL）적료효。방법：회고성분석26례청소년화성인초치채용개량Hyper-CVAD방안적LL환자자료。기중，22례불반골수수침적환자중，11례접수단순개량Hyper-CVAD방안치료，령외11례접수개량Hyper-CVAD방안연합HDT/AH?SCT공고치료。결과：전조61.5%（16/26）적환자초치체완전완해（complete remission，CR）혹불학정적CR（unconfirmed CR，CRu），중위수방29.5개월，5년적총생존（overall survival，OS）솔화무진전생존（progress-free survival，PFS）솔분별위66.8%화50.2%。22례무골수수침적환자중，단순Hyper-CVAD조여연합HDT/AHSCT조적5년OS솔분별위60.0%화70.7%（P=0.438），5년PFS솔분별위43.6%화62.3%（P=0.209），균무통계학차이。단인소예후분석결과현시，초치완해후1년내질병진전혹복발여예후불량상관（P=0.012）。결론：개량Hyper-CVAD방안시청소년화성인LL일선유효적치료방안。대우무골수침범적환자，단순개량Hyper?CVAD이능취득교호료효，연합HDT/AHSCT공고치료미능진일보개선예후。
Objectives: This study evaluated the efficiency of HyperCVAD regimen with or without high-dose therapy (HDT) combined with autologous hematopoietic stem cell transplantation (AHSCT) in lymphoblastic lymphoma (LL). Methods:Data of 26 adolescent and adult LL patients were retrospectively analyzed. These patients were initially treated with the modified HyperCVAD reg-imen in a basic institution. Except 4 of the total 26 patients who suffered bone-marrow involvements, 11 patients received consolidation treatment of HDT/AHSCT, and the other 11 did not. Results:Of the total patients, 61.5%achieved complete remission (CR) or uncon-firmed CR. With a median follow-up period of 29.5 months, the 5-year overall survival (OS) and progress-free survival (PFS) rates were 66.8% and 50.2%, respectively. Of the 22 patients without bone marrow involvement, the corresponding 5-year OS rates were 60.0%and 70.7%in the patients treated with the HyperCVAD regimen alone and in those who received HDT/AHSCT as consolidation therapy (P=0.438), with 5-year PFS rates of 43.6% and 62.3%, respectively (P=0.209). Disease progression or relapse within a year was identified as the only significant prognostic factor for OS in univariate analysis. Conclusion:The HyperCVAD regimen is an effec-tive initial therapy for adolescent and adult LL patients. For patients without bone marrow involvement, the HyperCVAD regimen com-bined with HDT/AHSCT is not superior over the HyperCVAD regimen alone.
