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目的 观察卡铂(CBP)、替尼泊苷(VM-26)、阿糖胞苷(Ara-C)和地塞米松(DXM)组成的CVAD方案治疗复发性非霍奇金淋巴瘤的临床疗效和毒性反应。方法 24例经正规CHOP方案治疗后复发的非霍奇金淋巴瘤患者,采用CVAD方案化疗。第1～5 d,静脉滴注C8P 60 mg·m～2·d～1、VM-26 60 mg·m～2·d～1、Ara—C 400 mg·m-2·d～1、DXM 10 mg·m -2·d～1,其中Ara—C和DXM分二次滴注。间隔3～4周,同一方案再行一次。结果 完成二个疗程后,完全缓解13例(54.2％),部分缓解8例(33.3％),进展3例,总有效率87.5％;中位生存期16个月。所有病例都出现造血功能抑制,但能恢复。按WHO判断标准,非血液系统毒性均表现为Ⅱ级以下,无尿素氮和肌酐增高。结论 CVAD方案治疗复发性非霍奇金淋巴瘤有效且毒性可耐受,尤其对多次使用CHOP的患者,可避免蒽琨类药物对心脏的毒性。
Objective To observe the clinical efficacy of CVAD regimen consisting of carboplatin (CBP), VM-26, Ara-C and DXM in the treatment of recurrent non-Hodgkin’s lymphoma And toxic reaction. Methods Twenty-four non-Hodgkin’s lymphoma patients who relapsed after regular CHOP regimen were treated with CVAD regimen. The first 5 days, intravenous drip C8P 60 mg · m ~ 2 · d ~ 1, VM-26 60 mg · m ~ 2 · d ~ 1, Ara-C 400 mg · m-2 · d ~ 10 mg · m -2 · d ~ 1, of which Ara-C and DXM were instilled twice. Intervals of 3 to 4 weeks, the same program again. Results After two courses of treatment, complete remission was achieved in 13 cases (54.2%), partial remission in 8 cases (33.3%) and progression in 3 cases. The total effective rate was 87.5%. The median survival time was 16 months. All cases have hematopoietic suppression, but can recover. According to the WHO criteria, non-hematological toxicity showed grade Ⅱ, no urea nitrogen and creatinine increased. Conclusions The CVAD regimen is effective and tolerable in the treatment of recurrent non-Hodgkin’s lymphoma. In particular, the CHAT regimen can avoid the toxicity of anthracycline to the heart.