苯达莫司汀联合R-CHOP方案对弥漫大B细胞淋巴瘤疗效及安全性的影响

刘亚宁; 李焱; 任利涛; 侯小雪; 王茜

doi:10.16766/j.cnki.issn.1674-4152.003587

苯达莫司汀联合R-CHOP方案对弥漫大B细胞淋巴瘤疗效及安全性的影响

doi: 10.16766/j.cnki.issn.1674-4152.003587

刘亚宁¹,
李焱^1, ,,
任利涛²,
侯小雪³,
王茜⁴

1.
邯郸市第一医院血液内科，河北邯郸 056002
2.
邯郸市第一医院医务科
3.
邯郸市第一医院重症医学科
4.
河北医科大学第二医院血液内科，河北石家庄 050004

基金项目:

河北省2023年度医学科学研究项目 20231188

详细信息

通讯作者:
李焱，E-mail：handanliyan68@sohu.com

中图分类号: R733.4 R730.53
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- 被引次数: 0
出版历程
- 收稿日期: 2023-12-14
- 网络出版日期: 2024-09-05

Effects of bendamustine combined with R-CHOP on the efficacy and safety of diffuse large B-cell lymphoma

1.
Department of Hematology, Handan First Hospital, Handan, Hebei 056002, China

摘要

摘要: 目的探究苯达莫司汀(BEN)联合利妥昔单抗+CHOP(R-CHOP)方案对弥漫大B细胞淋巴瘤(DLBCL)疗效、血清因子及不良反应的影响。方法选取2018年1月—2020年6月期间邯郸市第一医院收治的140例DLBCL患者，根据随机数字表法分为2组，分别采用R-CHOP方案(对照组, 70例)和BEN联合R-CHOP方案治疗(观察组, 70例)，比较2组疗效及安全性。结果观察组客观缓解率(ORR)高于对照组[85.71%(60/70) vs. 71.43%(50/70)，χ²=4.242，P < 0.05)；治疗后观察组糖类抗原125(CA125)、乳酸脱氢酶(LDH)、血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)、核转录因-κB p50(NF-κB p50)均低于对照组[(18.34±2.75)U/L vs. (22.54±3.11)U/L，(227.16±35.12)U/L vs. (282.71±37.46)U/L，(75.08±10.76)ng/L vs. (81.29±12.41)ng/L，(17.29±1.81)ng/L vs. (19.16±2.07)ng/L，(976.58±104.08)μg/L vs. (1 137.19±197.65)μg/L，P < 0.05]。2组治疗期间各不良反应发生率差异均无统计学意义(P>0.05)。观察组累计生存率及累计无进展生存率高于对照组(log-rank χ²=4.243、3.959，P=0.039、0.047)。结论 BEN联合R-CHOP方案能提高DLBCL患者的近远期疗效，改善血清指标，安全有效。
- 弥漫大B细胞淋巴瘤 /
- 苯达莫司汀 /
- R-CHOP方案 /
- 疗效 /
- 不良反应
Abstract: Objective To investigate the effects of bendamustine (BEN) combined with rituximab+cyclophosphamide, doxorubicin, vincristine, methylprednisolone (R-CHOP) regimen on the efficacy, serum factors, and adverse reactions in patients with diffuse large B-cell lymphoma (DLBCL). Methods A total of 140 DLBCL patients at Handan First Hospital from January 2018 to June 2020 were selected. Using a random number table, they were divided into 2 groups: the control group receiving R-CHOP and the observation group receiving BEN combined with R-CHOP. Their efficacy and safety of the two groups were then compared. Results The objective response rate (ORR) of the observation group was higher than that of the control group [85.71% (60/70) vs. 71.43% (50/70), χ²=4.242, P < 0.05]. Post-treatment, levels of carbohydrate antigen 125 (CA125), lactate dehydrogenase (LDH), vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), and nuclear transcription face-κB p50 (NF-κB p50) in the observation group were lower than those in the control group [(18.34±2.75) U/L vs. (22.54±3.11) U/L, (227.16±35.12) U/L vs. (282.71±37.46) U/L, (75.08±10.76) ng/L vs. (81.29±12.41) ng/L, (17.29±1.81) ng/L vs. (19.16±2.07) ng/L, (976.58±104.08) μg/L vs. (1 137.19±197.65) μg/L, P < 0.05]. There was no significant difference in the incidence of adverse reactions between the two groups during treatment (P>0.05). Furthermore, the cumulative survival rate and progression-free survival rate in the observation group were higher than those in the control group (log-rank χ²=4.243, 3.959, P=0.039, 0.047, respectively). Conclusion Combining BEN with R-CHOP improves the short-term and long-term efficacy of DLBCL patients, enhances serum indexes, and ensures safety and effectiveness.
- Diffuse large B-cell lymphoma /
- Bendamustine /
- R-CHOP protocol /
- Curative effect /
- Adverse reaction

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图 1 2组DLBCL患者生存曲线

Figure 1. Survival curves of DLBCL patients in two groups

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图 2 2组DLBCL患者无进展生存曲线

Figure 2. Progression-free survival curves of DLBCL patients in two groups

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表 1 2组DLBCL患者一般资料比较

Table 1. Comparison of general data between two groups of DLBCL patients

组别	例数	性别[例(%)]		年龄 (x±s, 岁)	分期[例(%)]			国际预后指数[例(%)]
组别	例数	男性	女性	年龄 (x±s, 岁)	Ⅰ期	Ⅱ期	Ⅲ期	低危~低中危	高中危~高危
观察组	70	37(52.86)	33(47.14)	49.71±4.12	21(30.00)	30(42.86)	19(27.14)	41(58.57)	29(41.13)
对照组	70	41(58.57)	29(41.43)	48.94±4.31	18(25.71)	27(38.57)	25(35.71)	38(54.29)	32(45.71)
统计量		0.463^a		1.082^b	1.207^a			0.261^a
P值		0.496		0.281	0.547			0.609
注：^a为χ²值，^b为t值。

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表 2 2组DLBCL患者临床疗效比较[例(%)]

Table 2. Comparison of clinical efficacy between two groups of DLBCL patients[case (%)]

组别	例数	CR	PR	SD	PD	ORR
对照组	70	37(52.86)	13(18.57)	11(15.71)	9(12.86)	50(71.43)
观察组	70	40(57.14)	20(28.57)	7(10.00)	3(4.29)	60(85.71)
注：2组ORR比较，χ²=4.242，P=0.039。

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表 3 2组DLBCL患者血清指标比较(x±s)

Table 3. Comparison of serum indexes between two groups of DLBCL patients (x±s)

组别	例数	CA125(U/L)		LDH(U/L)		VEGH(ng/L)		bFGF(ng/L)		NF-κB p50(μg/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	70	38.55±5.91	22.54±3.11^b	352.46±69.54	282.71±37.46^b	147.33±15.95	81.29±12.41^b	26.95±2.56	19.16±2.07^b	1 590.26±229.41	1 137.19±197.65^b
观察组	70	39.13±6.24	18.34±2.75^b	349.71±65.26	227.16±35.12^b	145.96±17.54	75.08±10.76^b	27.33±2.43	17.29±1.81^b	1 603.51±267.57	976.58±104.08^b
统计量		0.555^a	7.864^c	0.241^a	8.693^c	0.487^a	3.064^c	0.877^a	5.139^c	0.314^a	6.271^c
P值		0.580	< 0.001	0.810	< 0.001	0.627	< 0.001	0.382	< 0.001	0.754	< 0.001
注：^a为t值，^c为F值；与治疗前比较，^bP < 0.05。

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表 4 2组DLBCL患者Ⅲ级及以上药物不良反应发生率比较[例(%)]

Table 4. Comparison of Grade Ⅲ and above adverse drug reactions between two groups of DLBCL patients[case (%)]

组别	例数	恶心呕吐	白细胞减少	血小板减少	腹泻	肾功能异常
对照组	70	7(10.00)	5(7.14)	5(7.14)	3(4.29)	1(1.43)
观察组	70	10(14.29)	6(8.57)	4(5.71)	4(5.71)	3(4.29)
χ²值		0.603	0.099	< 0.001	< 0.001	0.257
P值		0.438	0.753	0.999	0.999	0.612

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