维布妥昔单抗联合化疗一线治疗晚期经典型霍奇金淋巴瘤的临床观察

刘林; 谢志滨; 王蒙

doi:10.16766/j.cnki.issn.1674-4152.004000

维布妥昔单抗联合化疗一线治疗晚期经典型霍奇金淋巴瘤的临床观察

doi: 10.16766/j.cnki.issn.1674-4152.004000

蚌埠医科大学第一附属医院血液科，安徽蚌埠 233004

基金项目:

安徽省教育厅科学研究重点项目 2023AH052011

蚌埠医学院自然科学重点项目 2022byzd048

蚌埠医学院自然科学重点项目 2022byzd053

详细信息

通讯作者:
王蒙，E-mail：514859030@qq.com

中图分类号: R733 R730.53
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出版历程
- 收稿日期: 2024-10-28
- 网络出版日期: 2025-08-14

Clinical observation of first-line treatment with Brentuximab Vedotin combined with chemotherapy in advanced classical Hodgkin lymphoma

Department of Hematology, the First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui 233004, China

摘要

摘要: 目的观察维布妥昔单抗(BV)联合多柔比星(A)、长春地辛(V)、达卡巴嗪(D)方案(BV-AVD)一线治疗晚期经典型霍奇金淋巴瘤(cHL)的应用效果。方法回顾性分析2021年8月—2023年1月蚌埠医科大学第一附属医院血液科收治的10例一线应用BV-AVD方案的晚期cHL患者的临床资料[性别、年龄、病理类型、原发部位、分期、国际预后评分(IPS)、免疫组化]，随访并判定疗效及观察并记录不良反应发生情况。结果 10例患者中男性6例、女性4例，年龄为(44.7±13.3)岁；6例病理类型为结节硬化型，4例混合细胞型；8例以表浅淋巴结肿大起病，其他还包括1例腹痛、1例胸骨后疼痛；7例分期Ⅳ期；5例IPS评分≥4分，5例起病时有B症状；免疫组化中5例EBER阳性，3例CD163阳性；2个周期治疗后客观缓解率(ORR)为100%，完全缓解率(CR)为80%；6个周期后9例可评价患者ORR和CR率均为89%，中位总生存期(OS)和无进展生存期(PFS)均未达到。CD163阳性患者的OS及PFS均短于CD163阴性患者(P=0.007和P=0.001)。不良反应主要为疲劳(8例)、恶心(8例)、中性粒细胞减少(7例)、中性粒细胞减少伴发热(6例)和周围神经病变(6例)等，仅2例发生最高3级的不良反应。结论晚期cHL患者一线应用BV-AVD方案短期随访疗效确切，不良反应可控。
- 经典型霍奇金淋巴瘤 /
- 维布妥昔单抗 /
- 一线治疗 /
- 联合化疗
Abstract: Objective To evaluate the effect of Brentuximab Vedotin (BV) combined with doxorubicin (A), vindesine (V), and dacarbazine (D) (BV-AVD-regimen) as first-line treatment for advanced classical Hodgkin lymphoma (cHL). Methods Clinical data of 10 patients with advanced cHL admitted to the Department of Haematology, the First Affiliated Hospital of Bengbu Medical University, from August 2021 to January 2023 with first-line application of the BV-AVD regimen were retrospectively analyzed. Data reviewed included general characteristics [gender, age, pathological type, primary site, stage, international prognostic score (IPS), and immunohistochemistry], treatment response, follow-up outcomes, and adverse reactions. Results Among the 10 patients, 6 were male and 4 were female, with a mean age of (44.7±13.3) years. Pathologically, 6 cases were classified as nodular sclerosis type and 4 as mixed cellularity type. Eight patients initially presented with superficial lymphadenopathy, while abdominal pain and retrosternal pain were reported in one case each. Seven patients were diagnosed with stage Ⅳ disease, and 5 had an international prognostic score (IPS) of ≥4. B symptoms were observed in 5 cases at diagnosis. Immunohistochemical analysis revealed EBER positivity in 5 patients and CD163 positivity in 3. After 2 cycles of treatment, the objective response rate (ORR) was 100%, with a complete response (CR) rate of 80%. Among the 9 evaluable patients after 6 cycles, both the ORR and CR rates were 89%. The median overall survival (OS) and progression-free survival (PFS) were not reached during follow-up. Patients with CD163 positivity had significantly shorter OS and PFS compared to CD163-negative patients (P=0.007 and P=0.001, respectively). The most common adverse events included fatigue (8 cases), nausea (8 cases), neutropenia (7 cases), febrile neutropenia (6 cases), and peripheral neuropathy (6 cases). Grade 3 adverse events occurred in only 2 patients. Conclusion The short-term follow-up indicates that fist-line BV-AVD treatment is effective in patients with advanced cHL, with manageable adverse effects.
- Classical Hodgkin lymphoma /
- Brentuximab Vedotin /
- First-line treatment /
- Combined chemotherapy

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图 1 10例晚期cHL患者的总生存曲线及疾病进展时间曲线

Figure 1. Overall survival curve (OS) and time to disease progression (PFS) in 10 Patients with advanced cHL

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表 1 10例晚期cHL患者的一般资料

Table 1. General data of 10 patients with advanced cHL

病例	性别	年龄	病理类型	原发部位	分期	IPS	B症状	EBER	CD163
1	男性	56	混合细胞型	淋巴结	Ⅲ	3	无	阴性	阴性
2	男性	33	结节硬化型	淋巴结、脾、骨	Ⅳ	2	无	阳性	阴性
3	女性	60	混合细胞型	淋巴结	Ⅲ	4	有	阴性	阴性
4	女性	49	结节硬化型	淋巴结、肝、脾、骨	Ⅳ	4	有	阳性	阳性
5	男性	39	结节硬化型	淋巴结、双肺、脾、骨	Ⅳ	2	有	阳性	阴性
6	女性	32	结节硬化型	淋巴结、右肺、纵隔、骨	Ⅳ	1	无	阳性	阴性
7	男性	52	结节硬化型	淋巴结、肝、脾、骨髓	Ⅳ	6	无	阳性	阳性
8	男性	64	结节硬化型	淋巴结、脾、骨	Ⅳ	4	有	阴性	阴性
9	女性	25	混合细胞型	淋巴结	Ⅲ	0	无	阴性	阴性
10	男性	37	混合细胞型	淋巴结、脾、骨髓	Ⅳ	5	有	阴性	阳性

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