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目的评价阿米福汀联合ESHAP(Amifostine-ESHAP)方案治疗复发或难治性中高度恶性非霍奇金淋巴瘤(NHL)的临床疗效和不良反应。方法采用Amifostine-ESHAP／ESHAP方案分组治疗38例复发或难治性中高度恶性NHL。结果Amifos- tine-ESHAP组21例患者共接受84个疗程化疗,10例完全缓解,4例部分缓解;ESHAP组17例患者共接受62个疗程化疗,7例完全缓解,3例部分缓解,总有效率分别为66．7％和58．8％,差异无统计学意义(P>0．05);2组中老年和年轻患者总有效率差异均无统计学意义(P>0．05)。2组主要治疗相关的不良反应为骨髓抑制,Amifostine-ESHAP组重度白细胞减少和血小板减少发生率分别为14．3％和23．8％,明显低于ESHAP组(35．3％和41．2％,以老年患者为主),其中老年和年轻患者的不良反应发生率无显著差异。结论Amifostine-ESHAP方案是复发或难治性中高度恶性NHL,尤其是老年患者的有效挽救治疗方案,其中阿米福汀能有效预防化疗相关的骨髓抑制而不影响其疗效。
Objective To evaluate the clinical efficacy and adverse effects of amifostine combined with ESHAP (Amifostine-ESHAP) in the treatment of relapsed or refractory middle-high grade non-Hodgkin’s lymphoma (NHL). Methods Amifostine-ESHAP / ESHAP regimen was used to treat 38 patients with recurrent or refractory middle-high grade NHL. Results In the Amifos-tine-ESHAP group, 21 patients received a total of 84 courses of chemotherapy, 10 were completely relieved and 4 were partly relieved. Seventeen patients in the ESHAP group received 62 courses of chemotherapy, 7 were completely relieved, 3 were partially relieved, The effective rates were 66.7% and 58.8% respectively, with no significant difference (P> 0.05). There was no significant difference in the total effective rate between the two groups (P> 0.05) . Adverse reactions to the two primary treatments were myelosuppression, rates of severe leukopenia and thrombocytopenia in the Amifostine-ESHAP group were 14.3% and 23.8%, respectively, significantly lower than those in the ESHAP group (35.3% vs 41.2% %, Mainly in elderly patients), of which the incidence of adverse reactions in elderly and young patients no significant difference. Conclusions The Amifostine-ESHAP regimen is an effective salvage regimen for relapsed or refractory middle and high-grade NHL, especially in elderly patients. Amifostine can effectively prevent chemotherapy-related myelosuppression without affecting its efficacy.