李文琪, 陈子琪, 孙金淼, 常宇, 柳喜洋, 张明智, 张蕾. R-BAP联合BTK抑制剂方案对初治套细胞淋巴瘤患者的疗效和安全性分析[J]. 中国肿瘤临床, 2023, 50(24): 1248-1253. DOI: 10.12354/j.issn.1000-8179.2023.20231336
引用本文: 李文琪, 陈子琪, 孙金淼, 常宇, 柳喜洋, 张明智, 张蕾. R-BAP联合BTK抑制剂方案对初治套细胞淋巴瘤患者的疗效和安全性分析[J]. 中国肿瘤临床, 2023, 50(24): 1248-1253. DOI: 10.12354/j.issn.1000-8179.2023.20231336
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Wenqi Li, Ziqi Chen, Jinmiao Sun, Yu Chang, Xiyang Liu, Mingzhi Zhang, Lei Zhang. Efficacy and safety analyses of R-BAP in combination with BTK inhibitors in newly diagnosed patients with mantle cell lymphoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2023, 50(24): 1248-1253. DOI: 10.12354/j.issn.1000-8179.2023.20231336
Citation: Wenqi Li, Ziqi Chen, Jinmiao Sun, Yu Chang, Xiyang Liu, Mingzhi Zhang, Lei Zhang. Efficacy and safety analyses of R-BAP in combination with BTK inhibitors in newly diagnosed patients with mantle cell lymphoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2023, 50(24): 1248-1253. DOI: 10.12354/j.issn.1000-8179.2023.20231336
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R-BAP联合BTK抑制剂方案对初治套细胞淋巴瘤患者的疗效和安全性分析

Efficacy and safety analyses of R-BAP in combination with BTK inhibitors in newly diagnosed patients with mantle cell lymphoma

    摘要
  • 摘要:
      目的  探讨以利妥昔单抗、苯达莫司汀、阿糖胞苷和泼尼松联合布鲁顿氏酪氨酸激酶（Bruton's tyrosine kinase，BTK）抑制剂的方案治疗MCL患者的疗效和安全性，旨在改良套细胞淋巴瘤（mantle cell lymphoma，MCL）的治疗方案。
      方法  回顾性分析郑州大学第一附属医院2021年3月至2023年11月收治的26例初治MCL病例，采用利妥昔单抗、苯达莫司汀、阿糖胞苷和泼尼松联合BTK抑制剂治疗方案的疗效和不良反应。
      结果  26例初治MCL患者中位年龄为59（41～72）岁，其中男性22例、女性4例，中位随访时间为12（3～28）个月。在26例患者中，总缓解率（overall response rate，ORR）为92.3%，完全缓解率（complete response rate，CRR）为88.5%。中位无进展生存期（progression-free survival，PFS）和中位总生存期（overall survival，OS）均未达到，1年PFS率为81.25%，1年OS率为92.3%。MCL国际预后指数（MIPI）评分0～3分组的PFS优于MIPI评分4～11分组（P=0.020），无B症状组的PFS优于有B症状组（P=0.002）, 经典型组的PFS优于母细胞样/多形性变异组（P=0.009）。主要不良反应为淋巴细胞和血小板减少症，在随访期间未观察到与治疗相关的严重不良事件发生。
      结论  利妥昔单抗、苯达莫司汀、阿糖胞苷和泼尼松联合BTK抑制剂的方案在初治MCL患者中治疗是安全有效的。

     

    Abstract:
      Objective  To improve the therapeutic regimen for mantle cell lymphoma, we investigated the efficacy and safety of adding a BTK inhibitor to a regimen including rituximab, bendamustine, cytarabine, and prednisone to treat patients with mantle cell lymphoma (MCL).
      Methods  Twenty-six patients newly diagnosed with MCL who were admitted to The First Affiliated Hospital of Zhengzhou University from March 2021 to November 2023 were treated with a regimen of rituximab, bendamustine, cytarabine and prednisone combined with a BTK inhibitor, and the efficacy and adverse effects of this regiment were retrospectively analyzed.
      Results  The median age of the 26 newly diagnosed MCL patients was 59 (41-72) years. The cohort included 22 males and 4 females, and the median follow-up time was 12 (3-28) months. The overall response rate (ORR) was 92.3% and the complete response rate (CRR) was 88.5%. Median progression-free survival (PFS) and median overall survival (OS) endpoints were not achieved, with a 1-year PFS rate of 81.25% and a 1-year OS rate of 92.3%. A better PFS was achieved in the low mantle cell lymphoma International Prognostic Index (MIPI) score (0-3 points) group than in the high MIPI score (4-11 points) group (P=0.020). PFS was better in the group without B symptoms than in the group with B symptoms (P=0.002). PFS was better in the classical group than in the pleomorphic-blastoid subtype group (P=0.009). The main adverse effects were lymphopenia and thrombocytopenia. No treatment-related serious adverse events were observed during the follow-up period.
      Conclusions  The regimen of rituximab, bendamustine, cytarabine, and prednisone in combination with BTK inhibitors is safe and effective for the treatment of newly diagnosed patients with MCL.

     

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