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目的:比较FC(氟达拉滨和环磷酰胺)和FCR(氟达拉滨、环磷酰胺和利妥昔单抗)方案治疗慢性淋巴细胞白血病(CLL)的临床疗效和预后影响。方法:回顾性分析本院2002年12月至2012年1月应用FC或FCR方案治疗的58例CLL患者病例资料,比较两种方案的疗效和预后影响。结果:FC组31例,FCR组27例。FCR组完全缓解(CR)率和总反应率(ORR)均高于FC组(44.4%vs.19.4%,P=0.039;81.5%vs.51.6%,P=0.017)。疗程结束后,FCR组患者获得微小残留病(microscopice residual disease,MRD)阴性比例高于FC组(37.0%vs.12.9%,P=0.032)。FCR和FC组患者中高危遗传学亚组患者PFS较非高危遗传学亚组患者短(P值分别为0.011,0.027),OS时间无明显差别。结论:FCR方案是治疗CLL患者的更为有效的方案。
OBJECTIVE: To compare the clinical efficacy and prognostic impact of FC (fludarabine and cyclophosphamide) and FCR (fludarabine, cyclophosphamide and rituximab) regimens in the treatment of chronic lymphocytic leukemia (CLL). Methods: The data of 58 CLL patients treated with FC or FCR regimen from December 2002 to January 2012 were retrospectively analyzed. The curative effect and prognosis of the two regimens were compared. Results: There were 31 cases in FC group and 27 cases in FCR group. The rates of complete remission (CR) and overall response (ORR) in the FCR group were significantly higher than those in the FC group (44.4% vs.19.4%, P = 0.039; 81.5% vs.51.6%, P = 0.017). At the end of the course of treatment, patients with FCR had a significantly lower rate of MRD than those with FC (37.0% vs. 12.9%, P = 0.032). PFS in patients with high-risk genetics in the FCR and FC groups were shorter than those in the non-high-risk genetics subgroup (P = 0.011, 0.027, respectively), and there was no significant difference in OS time. Conclusion: The FCR regimen is a more effective regimen for treating patients with CLL.