CAJ | 학술논문

目的：观察利妥昔单抗联合氟达拉滨和环磷酰胺（FCR）治疗慢性淋巴细胞白血病（CLL）的临床疗效和安全性。方法采用 FCR 方案治疗14例 CLL 患者，其中9例为初治患者，5例为复治患者。FCR 方案为利妥昔单抗375 mg·m-2，静脉滴注，第1天；氟达拉滨25 mg·m-2，静脉滴注，第2～4天；环磷酰胺250 mg·m-2，静脉滴注，第2～4天，28天为1周期。采用多参数流式细胞术（FCM）检测微量残留病（MRD），同时对临床指标与总反应率（ORR）行相关性分析。结果14例患者中，完全缓解（CR）6例（42.9％），部分缓解（PR）4例（28.6％），患者 ORR 为71.4％。低β2-微球蛋白水平、低 LDH 水平及治疗2疗程骨髓淋巴细胞比例下降≥50％与高 ORR 相关（P 值分别为0.035、0.011、0.005）；6例患者化疗后 MRD 阴性。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 方案治疗 CLL 临床疗效满意，不良反应可耐受。
목적：관찰리타석단항연합불체랍빈화배린선알（FCR）치료만성림파세포백혈병（CLL）적림상료효화안전성。방법채용 FCR 방안치료14례 CLL 환자，기중9례위초치환자，5례위복치환자。FCR 방안위리타석단항375 mg·m-2，정맥적주，제1천；불체랍빈25 mg·m-2，정맥적주，제2～4천；배린선알250 mg·m-2，정맥적주，제2～4천，28천위1주기。채용다삼수류식세포술（FCM）검측미량잔류병（MRD），동시대림상지표여총반응솔（ORR）행상관성분석。결과14례환자중，완전완해（CR）6례（42.9％），부분완해（PR）4례（28.6％），환자 ORR 위71.4％。저β2-미구단백수평、저 LDH 수평급치료2료정골수림파세포비례하강≥50％여고 ORR 상관（P 치분별위0.035、0.011、0.005）；6례환자화료후 MRD 음성。FCR 방안적불량반응주요표현위골수억제화위장도반응。결론FCR 방안치료 CLL 림상료효만의，불량반응가내수。
Objective To evaluate the efficacy and safety of combined chemoimmunotherapy of rituximab, fludarabine and cyclophosphamide (FCR) for patients with chronic lymphocytic leukemia (CLL). Methods A total of 14 patients with CLL were treated by FCR regimen which consisted of rituximab (375 mg·m-2, d1), fludarabine (25 mg·m-2, d2 to d4) and cyclophosphamide (250 mg·m-2, d2 to d4), in a treatment cycle of 28 days. The minimal residual disease (MRD) was deter-mined by multiparameter flow cytometry. The correlation between the clinical characteristics and overall response rate (ORR) was analyzed. Results Six patients (42.9%) achieved complete remission (CR) and 4 (28.6%) achieved partial remission (PR), with an overall response (OR) rate of 71.4%. The pretreatment parameters which were independently associated with higher ORR were lowβ2-MG, low lactate dehydrogenase (LDH) and proportions of bone marrow lymphocytes declined ≥50% af-ter 2 cycles of FCR (P=0.035, 0.011, 0.005, respectively). MRD was less than l% in 6 patients. The most common toxicities were myelosuppression and gastrointestinal reaction. Conclusion FCR regimen could achieve satisfactory efficacy in the treatment of adults with chronic lymphocytic leukemia, and the toxicity was tolerable.