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目的:观察分析美罗华(利妥昔单抗)在套细胞淋巴瘤(MCL)治疗中的临床价值。方法:选取套细胞淋巴瘤患者30例,随机分为观察组和对照组各15例,对照组给予CHOP方案进行治疗(第1天环磷酰胺750 mg/m2静脉滴注,第1天阿霉素50 mg/m2静脉滴注,第1天长春新碱1.4 mg/m2静脉滴注,第1~5天泼尼松100 mg/d口服),21 d为1个疗程,共治疗6~8个疗程。观察组在对照组方案基础上联合美罗华375 mg/m2静脉滴注(R-CHOP方案),于治疗第1天使用;21 d为1个疗程,共治疗4~6个疗程。观察对比两组患者的临床效果。结果:观察组患者中完全缓解6例,部分缓解7例,无效2例;对照组部分缓解5例,无效10例;观察组患者缓解率明显高于对照组(P<0.05)。两组患者于治疗期间均未出现与用药相关的不可逆性器官损害;观察组不良反应以胃肠道反应为主者6例,以肝功能异常为主者5例,以骨髓抑制为主者4例;对照组出现不良反应以胃肠道反应为主者10例,以肝功能异常为主者4例,以骨髓抑制为主者1例。两组不良反应发生情况比较差异无统计学意义(P>0.05)。结论:套细胞淋巴瘤应用常规CHOP方案难以收到满意效果,联用美罗华后疗效明显提高,且未见明显严重不良反应的发生。
Objective: To observe and analyze the clinical value of rituximab in the treatment of mantle cell lymphoma (MCL). Methods: Thirty patients with mantle cell lymphoma were randomly divided into observation group (15 cases) and control group (15 cases). The control group was treated with CHOP regimen (cyclophosphamide 750 mg / m2 on day 1, Intravenous infusion of 50 mg / m2, vincristine 1.4 mg / m2 on day 1, prednisone 100 mg / d on days 1-5) and 21 days for a course of treatment of 6 to 8 A course of treatment. The observation group received Rituximab 375 mg / m2 intravenous infusion (R-CHOP) on the basis of the control group, and was used on the first day of treatment. On the 21st day, a course of treatment was given for 4 to 6 courses. Observed and compared the clinical effect of two groups of patients. Results: In the observation group, 6 cases were completely relieved, 7 cases partially relieved, 2 cases ineffective; 5 cases partially relieved and 10 ineffective in the control group. The response rate in the observation group was significantly higher than that in the control group (P <0.05). The two groups of patients did not appear during the treatment of drug-related irreversible organ damage; observation group adverse reactions to gastrointestinal reactions mainly in 6 cases, 5 cases of liver dysfunction mainly to bone marrow suppression in 4 cases ; Adverse reactions in the control group to gastrointestinal reactions in 10 cases, mainly in 4 cases of liver dysfunction, bone marrow suppression in 1 case. There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). CONCLUSIONS: The mantle cell lymphoma is difficult to receive satisfactory results when using conventional CHOP regimen. The combined effect of rituximab was significantly improved, and no serious adverse reactions were observed.