摘要
目的探讨利妥昔单抗联合CHOP方案治疗弥漫大B细胞淋巴瘤(DLBCL)的疗效与预后因素分析。方法回顾性分析2014年1月至2018年5月在郑州市中医院就诊的59例DLBCL患者的临床资料。按照不同治疗方案分成对照组18例和观察组41例。对照组应用CHOP化疗,观察组在此基础上联用利妥昔单抗,疗程4个周期。治疗结束后,比较两组行疗效。根据生存曲线分析患者预后,采用单因素分析和多元Logistic回归模型分析患者疗效与预后影响因素分析评价。结果观察组有效率92.68%,高于对照组72.22%,差异有统计学意义(P<0.05)。单因素分析显示,是否初次治疗、改良Ann Arbor分期、有无骨髓侵犯、红细胞沉降率(ESR)、血清乳酸脱氢酶(LDH)水平、国际预后指数(IPI)评分、有无淋巴瘤B症状和是否联用利妥昔单抗均是影响患者疗效的相关因素;Logistic回归分析显示,改良Ann Arbor分期、ESR、IPI评分、有无淋巴瘤B症状和是否联用利妥昔单抗是影响患者疗效的独立危险因素,差异有统计学意义(P<0.05)。根据生存曲线结果显示,观察组中位生存时间65.25个月,高于对照组的50.04个月中位生存时间,差异有统计学意义(P<0.05)。单因素分析显示,是否初次治疗、改良Ann Arbor分期、有无骨髓侵犯、ESR、LDH水平、IPI评分、淋巴瘤B症状、ECOG评分和是否联用利妥昔单抗均是影响患者预后的相关因素;Logistic回归分析显示,改良Ann Arbor分期、LDH水平、IPI评分和是否联用利妥昔单抗均是影响患者预后的独立危险因素,差异有统计学意义(P<0.05)。结论利妥昔单抗联合CHOP方案治疗弥漫大B细胞淋巴瘤能够提高疗效,改善预后。改良Ann Arbor分期、ESR、IPI评分、有无淋巴瘤B症状和是否联用利妥昔单抗均是影响患者疗效的独立危险因素。改良Ann Arbor分期、LDH水平、IPI评分和是否联用利妥昔单抗均是影响患者预后的独立因素。
Objective To investigate the efficacy of rituximab combine with CHOP regimen in the treatment of diffuse large B-cell lymphoma(DLBCL),and to analyze the factors influencing the efficacy and prognosis.Methods The clinical data of 59 patients with DLBCL treated in our hospital from January 2014 to may 2018 were retrospectively analyzed.The patients were divided into observation group(41 cases)and control group(18 cases).According to different treatment schemes,the patients were divided into control group and observation group.The control group was treated with CHOP chemotherapy,and the observation group was treated with rituximab on this basis.The course of treatment was 4 cycles.After the treatment,the curative effect of the two groups was evaluated.Survival curve was used to analyze the prognosis.Univariate analysis and multiple logistic regression model were used to analyze the influencing factors of curative effect and prognosis.Results The total effective rate was 92.68%in the observation group,higher than 72.22%in the control group(P<0.05).Univariate analysis showed that initial treatment,improved Ann Arbor staging,presence or absence of bone marrow invasion,erythrocyte sedimentation rate(ESR),serum lactate dehydrogenase(LDH)level,Iinternational prognostic index(IPI)score,presence or absence of lymphoma B symptoms and combination of rituximab were all relevant factors affecting the outcome of the patients(P<0.05).Logistic regression analysis showed that improved Ann Arbor staging,ESR,IPI score,presence or absence of lymphoma B symptoms and combination of rituximab were independent risk factors affecting the efficacy of patients(P<0.05).The survival curve results showed that the median survival time of the observation group was 65.25 months,higher than 50.04 months of the control group(P<0.05).Univariate analysis showed that initial treatment,improved Ann Arbor staging,presence or absence of bone marrow invasion,ESR,LDH level,IPI score,lymphoma B symptoms,physical condition score(ECOG)score and combination of rituximab were all relevant factors affecting the prognosis of patients(P<0.05).Logistic regression analysis showed that improved Ann Arbor staging,LDH level,IPI score and combination of rituximab were independent risk factors affecting the prognosis of patients(P<0.05).Conclusion Rituximab combined with CHOP regimen can improve the efficacy and prognosis of DLBCL.The improved Ann Arbor staging,ESR,IPI score,presence or absence of lymphoma B symptoms and combination of rituximab were independent risk factors affecting the efficacy of patients.The improved Ann Arbor staging,LDH level,IPI score and combination of rituximab were independent factors influencing the prognosis of patients.
作者
赵博
ZHAO Bo(Preparation Room,Zhengzhou Hospital of Traditional Chinese Medicine,Zhengzhou Henan 450000,China)
出处
《临床研究》
2022年第6期36-40,共5页
Clinical Research
