伊布替尼单药方案与CHOP方案治疗慢性淋巴细胞白血病的临床疗效观察
Clinical Efficacy of Ibrutinib Monotherapy and CHOP in the Treatment of Chronic Lymphocytic Leukemia
DOI: 10.12677/ACM.2020.1011428, PDF,   
作者: 段春英, 袁海峰, 宋 峤, 曹 正：青岛大学医学部，山东 青岛；吴少玲*：青岛大学附属医院血液科，山东 青岛
关键词: 伊布替尼；CHOP；慢性淋巴细胞白血病；有效性；安全性；Brutinib； CHOP； Chronic Lymphocytic Leukemia； Effectiveness； Security
摘要: 目的：观察伊布替尼单药方案与CHOP方案治疗初治慢性淋巴细胞白血病的临床疗效及安全性。方法：回顾性分析2014年03月~2020年03月在青岛大学附属医院血液科治疗的48例初治慢性淋巴细胞白血病患者，根据治疗方案不同，将其分为伊布替尼组(30例)及CHOP组(18例)，对比两组治疗方案的临床疗效及不良反应。结果：本研究共纳入48例患者，结果显示伊布替尼组的总有效率(0RR)高于CHOP组(93.33% vs 40.00%)，p < 0.01；伊布替尼组患者1年无进展生存(PFS)率明显高于CHOP组(80.00% vs 33.33%)，差异有统计学意义(P < 0.05)；伊布替尼组患者1年总生存率(OS)为96.67%，而CHOP组为63.33%，差异有统计学意义(P < 0.05)；在接受伊布替尼治疗的患者中，36.67%发生了不良事件，包括出血、房颤、腹泻、感染等；在接受CHOP方案治疗的患者中，有53.33%发生不良反应，包括中性粒细胞减少、贫血、出血和呕吐。结论：伊布替尼治疗初治慢性淋巴细胞白血病患者可达到较高的缓解率，延长无进展生存期，不良反应多为I~II级，较传统化学疗法具有更好的耐受性。
Abstract: Objective: To observe the clinical efficacy and safety of ibrutinib single drug regimen and CHOP regimen in the treatment of primary chronic lymphocytic leukemia. Methods: A retrospective analysis was performed on 48 newly treated patients with chronic lymphocytic leukemia who were treated in the hematology department of Qingdao University Hospital from March 2014 to March 2020. According to different treatment regiments, they were divided into ibrutinib group (30 cases) and CHOP group (18 cases). The clinical efficacy and adverse reactions of treatment regiments of the two groups were compared. Results: A total of 48 patients were included in this study. The results showed that the total effective rate (0RR) of the ibrutinib group was higher than that of the CHOP group (93.33% vs 40.00%), P = 0.009. The 1-year progression-free survival (PFS) rate in the ibrutinib group was significantly higher than that in CHOP group (80.00% vs 33.33%), and the difference was statistically significant (P = 0.025). 1-year overall survival (OS) was 96.67% in the ibrutinib group, and 63.33% in CHOP group, with statistically significant differences (P = 0.003). Among patients treated with ibrutinib, 36.67% had adverse events, including bleeding, atrial fibrillation, diarrhea, infection, etc. Adverse reactions, including neutropenia, anemia, bleeding, and vomiting, occurred in 53.33% of patients treated with CHOP. Conclusion: Ibrutinib can achieve higher remission rate and prolong progression free survival time in newly diagnosed patients with chronic lymphoblastic leukemia. The adverse reactions are mostly grade I - II, which is more tolerable than traditional chemotherapy.
文章引用：段春英, 吴少玲, 袁海峰, 宋峤, 曹正. 伊布替尼单药方案与CHOP方案治疗慢性淋巴细胞白血病的临床疗效观察[J]. 临床医学进展, 2020, 10(11): 2819-2826. https://doi.org/10.12677/ACM.2020.1011428

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