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背景与目的:氟达拉滨是抗病毒药阿糖腺苷的氟化核苷酸类似物,用于治疗慢性淋巴细胞性白血病和复发耐药的惰性淋巴瘤已显示了疗效。本研究的目的为评价氟达拉滨联合方案治疗恶性淋巴瘤的疗效和安全性。方法:2004年1月至2005年11月间本科收治经组织学确诊的接受含氟达拉滨联合化疗的恶性淋巴瘤患者共19例,其中惰性淋巴瘤患者11例,复发的进展性淋巴瘤患者8例。11例惰性淋巴瘤患者中,6例接受了FND(氟达拉滨25mg/m2Ⅳd1~3;米托蒽醌10mg/m2Ⅳd1;地塞米松20mg PO d1~5,每4周重复)方案,5例接受了FC(氟达拉滨25mg/m2IV d1~3;环磷酰胺300mg/m2Ⅳd1~3,每4周重复)方案。所有进展性淋巴瘤患者均接受了FND方案。结果:接受FND或FC化疗的惰性淋巴瘤患者,有效率91%,完全缓解(CR)率45.5%。进展性淋巴瘤患者中2例达部分缓解(PR),有效率25%。全组有效率63.1%。主要不良反应为骨髓抑制。FND组有69.5%周期发生Ⅲ/Ⅳ度中性粒细胞减少,FC组无Ⅳ度中性粒细胞减少,仅22.2%周期发生Ⅲ度中性粒细胞减少。发生肺部感染4例,外阴尖锐湿疣1例。其他不良反应均为轻度,以消化道反应为主。结论:含氟达拉滨的联合方案,对于惰性淋巴瘤患者具有肯定的疗效,不良反应可以耐受。
BACKGROUND & AIM: Fludarabine is a fluorinated nucleotide analogue of the antiviral drug vidarabine and has been shown to be effective in the treatment of chronic lymphocytic leukemia and recurrent resistant indolent lymphomas. The purpose of this study was to evaluate the efficacy and safety of fludarabine in the treatment of malignant lymphoma. Methods: Nineteen patients with histologically confirmed malignant lymphoma who received fludarabine combined with chemotherapy were enrolled in our department from January 2004 to November 2005. Among them, 11 were patients with idiopathic lymphoma, 11 with recurrent progressive lymphoma 8 patients. Of the 11 patients with indolent lymphoma, 6 received FND (fludarabine 25 mg / m2 IV d1-3; mitoxantrone 10 mg / m2 IV d1; dexamethasone 20 mg PO d1-5 every 4 weeks) and 5 Received FC (fludarabine 25mg / m2IV d1 ~ 3; cyclophosphamide 300mg / m2Ⅳd1 ~ 3, repeated every 4 weeks) program. All patients with advanced lymphoma received the FND protocol. Results: In patients with indolent lymphoma receiving FND or FC chemotherapy, the response rate was 91% and the rate of complete remission (CR) 45.5%. Two patients with progressive lymphoma reached partial remission (PR), with an effective rate of 25%. The whole group of 63.1% efficiency. The main adverse reaction is myelosuppression. FND group had 69.5% cycles of Ⅲ / Ⅳ neutropenia, FC group no neutropenia, only 22.2% of the cycle of Ⅲ degree neutropenia. 4 cases of pulmonary infection occurred, 1 case of genital warts. Other adverse reactions are mild, mainly gastrointestinal reactions. CONCLUSION: The combination regimen with fludarabine has a positive effect on patients with indolent lymphoma and the adverse reactions are tolerable.