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目的对比MINE方案(异环磷酰胺、美司钠、米托蒽醌及足叶乙甙)与GDP方案(吉西他滨、地塞米松、顺铂)治疗老年复发、难治性弥漫大B细胞淋巴瘤(DLBCL)的疗效和不良反应,以期找到更好、更安全治疗老年复发、难治性DLBCL方案。方法选择老年复发、难治性DLBCL患者35例,既往均接受过2~6个期的CHOP或CHOP样方案化疗复发或进展。随后分别给予MINE或GDP方案化疗,其中GDP方案21例(GDP组),MINE方案14例(MINE组),其中GDP方案2个疗程未达部分缓解(PR)再行MINE方案化疗4例,中位疗程数3个周期(2~6个周期)。比较2组疗效和不良反应。结果 2组完全缓解(CR)、PR及总有效率(OS)比较差异均无统计学意义(P>0.05),2组粒细胞、血小板减少发生率比较差异均无统计学意义(P>0.05)。结论 MINE方案治疗老年复发、难治性DLBCL安全有效,可作为二线方案选择。
Objective To compare the effects of MINE regimen (ifosfamide, mesna, mitoxantrone and etoposide) and GDP regimen (gemcitabine, dexamethasone and cisplatin) in the treatment of relapsed and refractory diffuse large B cell lymphoma (DLBCL) efficacy and adverse reactions in order to find a better and safer treatment of relapsed and refractory DLBCL programs. Methods Thirty-five elderly patients with relapsed or refractory DLBCL were enrolled in the study. All of them had been treated with CHOP or CHOP-like regimens for 2 to 6 relapse or progression. Then, they were given MINE or GDP regimen respectively. Among them, 21 cases were GDP regimen (GDP group) and 14 cases were MINE regimen (MINE group). Among them, 2 regimens of partial regimen of GDP regimen failed partial remission (PR) and 4 cases of MINE regimen chemotherapy The number of treatment courses 3 cycles (2 to 6 cycles). The efficacy and adverse reactions of two groups were compared. Results The complete remission (CR), PR and total effective rate (OS) in the two groups had no significant difference (P> 0.05). There was no significant difference in the incidence of granulocyte and thrombocytopenia between the two groups (P> 0.05 ). Conclusions The MINE regimen is safe and effective in elderly relapsed and refractory DLBCL and can be used as a second-line regimen.