GDP方案治疗复发和难治性中高度恶性非霍奇金淋巴瘤

摘要

目的 探讨GDP方案(吉西他滨、顺铂、地塞米松)治疗复发和难治性中高度恶性非霍奇金淋巴瘤(NHL)的疗效和患者不良反应.方法 回顾性分析用GDP方案治疗的32例复发和难治性NHL患者的临床资料,其中复发性NHL 20例,难治性NHL 12例.结果 32例患者均可评价疗效和不良反应,采用GDP方案化疗总的客观有效率59.4%(19/32).完全缓解率21.8%(7/32),其中B细胞NHI洧效率为60.8%,T细胞NHL有效率为55.5%.全组总的1年生存率为43.8%.主要不良反应为骨髓抑制,其中Ⅲ～Ⅳ度血小板减少的发生率为31.1%,Ⅲ～Ⅳ度中性粒细胞减少的发生率为18.6%,恶心呕吐反应较轻微,经过治疗均可恢复,无治疗相关死亡.结论 GDP方案治疗复发和难治性中高度恶性NHL疗效肯定,不良反应相对较低,值得在更多病例中进一步研究.%Objective Treatment of relapsed and refractory non-Hodgkin lymphoma(NHL)remains difficult.This study investigated the efficacy of the GDP(gemcitabine,dexamethasone,and cisplatin)regimen on relapsed and refractory NHL and observed the corresponding adverse events.Methods Clinical data of 32 patients with relapsed and refractory NHL(20 relapsed NHL and 12 refractory NHL)treated with GDP regimen were analyzed.Results All the 32 patients were assessable.The response rate(RR)for the whole group was 59.4 % with complete remission(CR)rate of 21.8 %.Among the 23 patients with B-cell NHL and the 9 patients with T-cell NHL,the response rates were 60.8 % and 55.5 %,respectively.The 1-year overall survival rate was 43.8 %.Major toxicity was myelosuppression with 31.1% and 18.6 % incidence of grade Ⅲ-Ⅳ thrombecytopenia and neutropenia respectively.Nausea and vomiting toxicities were mild.These adverse effects could be treated and there was no treatment-treated death.Conclusion GDP regimen is effective and well tolerated in patients with relapsed and refractory NHL.Further clinical study is needed.