注射用盐酸苯达莫司汀单药治疗利妥昔单抗耐药的B细胞惰性淋巴瘤

摘要

目的：观察注射用盐酸苯达莫司汀单药治疗利妥昔单抗耐药的B细胞惰性淋巴瘤临床疗效及安全性。方法：25例利妥昔单抗治疗失败的B细胞惰性淋巴瘤患者，接受苯达莫司汀单药化疗（120 mg/m2，d1、2，每21天为1个周期），评价其近期疗效、无进展生存期与不良反应。结果：全组25例患者，共计化疗122个周期，中位5个周期。治疗2个周期后均可评价疗效，其中完全缓解（CR/CRu）6例，部分缓解（PR）13例，稳定（SD）3例，进展（PD）3例，总有效率（ORR）为76%，临床受益率（CBR）为88%。截至随访结束，13例患者出现PFS终点事件，中位疗效持续时间（DOR）8个月，中位无进展生存期（PFS）9个月。各亚组间无进展生存期的关系，主要与骨髓受累、血清LDH水平升高有关，差异有统计学意义（P<0.05）。常见不良反应为骨髓抑制、胃肠道反应和感染，2例患者出现皮疹，1例患者用药5个周期后发生胃癌。结论：注射用盐酸苯达莫司汀单药治疗利妥昔单抗耐药的B细胞惰性淋巴瘤可提高疗效，且耐受性良好。%Objective:To observe the clinical efficacy and toxicities of bendamustine hydrochloride in patients with rituximab-re-fractory indolent B-cell non-Hodgkin's lymphoma (NHL). Methods:A total of 25 patients with rituximab-refractory NHL received bendamustine hydrochloride 120 mg/m2 intravenously on days 1 and 2 of the 21-day cycle. The short-term response, progression free survival, and toxicities were evaluated. Results:The total number of chemotherapy of the 25 patients was 122 cycles, and the median number was 5 cycles. All patients could be evaluated for efficacy. Among the patients, 6 had complete remission, 13 had partial remis-sion, 3 had stable disease, and 3 had progression disease. The overall response rate and clinical benefit rate were 76%and 88%, respec-tively. Until the deadline, 13 patients had progression disease. The median duration of response was 8 months, and the median progres-sion-free survival (PFS) was 9.3 months. Subgroup analysis showed that PFS is significantly related to bone marrow involvement and serum LDH level (P<0.05). The main adverse effects were myelosuppression, gastrointestinal reactions, and infection. Rash was found in 2 patients, and 1 case of gastric cancer was discovered after 5 cycles of treatment. Conclusion:Bendamustine hydrochloride was ef-fective and tolerable in patients with rituximab-refractory indolent B-cell NHL.