改良Hyper-CVAD/MA方案治疗儿童淋巴母细胞性淋巴瘤的疗效观察
Efficacy of Modified Hype-CVAD/MA Treatment in Children LBL
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摘要: 目的 观察改良Hyper-CVAD/MA方案在儿童淋巴母细胞性淋巴瘤(LBL)初始治疗中的临床疗效。方法总结改良Hyper-CVAD/MA方案(分为A方案和B方案)初始治疗11例儿童LBL患者的临床资料。结果11例患者共完成A方案41例次,B方案40例次,鞘内注射34例次。化疗相关不良反应主要为骨髓抑制100%(81/81)、胃肠道反应39.5%(32/81)、细菌感染33.3%(27/81)、肝损害14.8%(12/81),均未影响化疗进程。1~2疗程化疗后完全缓解(CR)27.3%(3/11 ),部分缓解(PR)45.4%(5/11),疾病稳定(SD)27.3%(3/11);3~4疗程后CR 72.7%(8/11),PR 18.2%(2/11),SD 9.1%(1/11);6~8疗程后CR 81.8%(9/11),PR 9.1%(1/11),疾病进展(PD)9.1%(1/11),总体缓解率为90.9%。中位随访时间19月,平均(23.6±15.4)月,无病生存9例,带瘤生存1例,死亡1例。结论改良Hyper-CVAD/MA方案初始治疗儿童LBL患者疗效满意,化疗相关不良反应易耐受。Abstract: Objective To study the clinical efficacy of modified Hype-CVAD/MA regimen in children lymphoblastic lymphoma (LBL) patients. Methods Eleven children LBL cases accepted modified Hype-CVAD/MA regimen were divided into group A and B. Results Eleven cases totally received 41 cycles of regimen A,40 cycles of regimen B and 34 cycles of intrathecal injection.The adverse reactions of chemotherapy included bone marrow inhibition 100% (81/81),gastrointestinal reaction 39.5% (32/81),bacterial infections 33.3% (27/81),stomatitis 30.8% (25/81),shallow phlebitis 28.3% (23/81),liver damage14.8% (12/81),but all of those didn′t affect chemotherapy process.1~2 cycles later,the complete remission (CR) rate was 27.3% (3/11),partly remission (PR) 45.4% (5/11) and disease stable (SD) 27.3% (3/11);after 3~4 cycles,CR was 72.2% (8/11),PR 18.2% (2/11) and SD 9.1% (1/11);6~8 cycles later,CR was 81.8 % (9/11),PR 9.1% (1/11),and progressive disease (PD) 9.1% (1/11).The total remission rate was 90.9%.After median 19 months (average 23.6 ± 15.4 months) follow-up,disease-free survival had 9 cases,1 case survival with tumor and 1 case death. Conclusion The efficacy of modified Hype-CVAD/MA regimen as a initial treatment in children LBL was favourable,and adverse reactions were tolerable.