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目的观察硼替佐米为主的联合方案治疗难治复发非霍奇金淋巴瘤的疗效和不良反应。方法选择难治复发非霍奇金淋巴瘤患者5例,采用至少2个疗程的硼替佐米(1.3 mg/m2,第1、4、8、11天)联合化疗,分别联合脂质体阿霉素、脂质体阿霉素+地塞米松、吉西他滨+顺铂+地塞米松、吉西他滨+顺铂+地塞米松+左旋门冬酰胺酶和环磷酰胺+阿霉素+依托泊苷+强的松+左旋门冬酰胺酶等。采用国际淋巴瘤工作组(IWG)标准判断疗效,化疗相关不良反应根据WHO标准分级。结果 5例患者中,1例达完全缓解,其余4例达部分缓解;其中达完全缓解的为套细胞淋巴瘤,停化疗21个月后仍处于完全缓解状态,其余4例达部分缓解的分别是弥漫大B细胞淋巴瘤2例,结外NK/T细胞淋巴瘤1例和外周T细胞淋巴瘤1例。常见不良反应包括乏力(3例),血小板减少(4例),胃肠道反应(4例),周围神经病变(2例)等,经药物预防或对症处理均可减轻或缓解。结论硼替佐米为主的联合方案是一种对难治复发非霍奇金淋巴瘤新的治疗选择。
Objective To observe the efficacy and side effects of bortezomib-based combination regimen in the treatment of refractory recurrent non-Hodgkin’s lymphoma. Methods Five patients with refractory recurrent non-Hodgkin’s lymphoma were enrolled in this study. Bortezomib (1.3 mg / m 2, days 1,4,8 and 11) was used in combination with chemotherapy for at least 2 cycles. , Liposomal doxorubicin + dexamethasone, gemcitabine + cisplatin + dexamethasone, gemcitabine + cisplatin + dexamethasone + L-asparaginase and cyclophosphamide + doxorubicin + etoposide + strong Pine + L-asparaginase and so on. The International Lymphoma Working Group (IWG) criteria were used to evaluate the efficacy of chemotherapy-related adverse reactions according to WHO criteria. Results Of the 5 patients, one was completely relieved and the other four were partially relieved. The complete remission was mantle cell lymphoma. After 21 months of chemotherapy, the symptoms were still completely relieved and the remaining four patients achieved partial remission Two cases were diffuse large B cell lymphoma, one case had extranodal NK / T cell lymphoma and one case had peripheral T cell lymphoma. Common adverse reactions include fatigue (3 cases), thrombocytopenia (4 cases), gastrointestinal reactions (4 cases), peripheral neuropathy (2 cases), etc., by drug prevention or symptomatic treatment can reduce or alleviate. Conclusion Bortezomib-based regimen is a new treatment option for refractory and relapsed non-Hodgkin’s lymphoma.