| Background:There is an increasing tendency of lymphoma occurrence, which derived from lympho-hamotolage system. Despite a large number of achievements for aggressive lymphoma has been achieved, there are still about50%of patients suffering from the progressive of non-hodgkin lymphoma. This situation has close relationship with the tissue type, biological behavior of non-hodgkin lymphoma and patients’special corporeity. Although many application of treatment methods for refractory or relapse non-hodgkin lymphoma, such as allogenic stem cell transplantation, molecular targeted therapy and so on, had been appeared, but the consensus among different international communities has not been accepted. Chemotherapy is still one of the most fitful choices. Gemcitabine is a pyrimidine analogs, which can inhibited tumor cell growth and inducted apoptosis by interfering with DNA synthesis and repair. Gemcitabine is focused by non-hodgkin lymphoma researchers ony its more powerful activity and less adverse reactions, in contrast with cytarabine. It is uncertain that whether gemcitabine has more advantages than other second-line chemotherapy without gemcitabine. On the other hand which kind of patints, which type of lymphoma suitable for the chemotherapy with gemcitabine is still a problem.Objective:1) Research the efficacy and adverse reaction of the chemotherapy contained gemcitabine in the treatment of refractory or relapsed lymphoma.2) Comparing the curative efficacy and adverse reaction between the chemotherapy contained gemcitabine with the chemotherapy not contained gemcitabine.Methods:A retrospective study was used. Analyse53refractory and relapsed lymphoma patients who had been received the first-line chemotherapy between2009.01.01to2012.12.31. Among those patients,38patients got chemotherapy contained gemcitabine (gemcitabine group) and15patients got other second-line chemotherapy without gemcitabine (non-gemcitabine group). The efficacy and adverse effect of patients who got chemotherapy contained gemcitabine was analyzed, especially patients more than60-year-old. the efficacy and adverse effect was compared between gemcitabine group and non-gemcitabine group.Result1) The overall response rate (ORR) of gemcitabine group was36.8%(14/38), complete remission(CR) was5.2%and partial remission (PR) was13.3%. In gemcitabine group,8patients got stage Ⅲ/Ⅳ adverse effect. The incidence of bone marrow suppression is13%(5/38). And the incidence of gastrointestinal reaction is8%(3/38)2) In gemcitabine group, the ORR of22B-cell lymphoma patients is40.9%(9/22), the ORR of26T-cell lymphoma is31.3%. No statistical difference was seen.3) In non-gemcitabine group, the ORR is20%(3/15), which is not statistically different with ORR in gemcitabine group(36.8%). The CR rate in non-gemcitabine group is13.3%, which is still not statistically different with the CR rate in gemcitabine group(5.2%). The PR rate6.7%in non-gemcitabine group. The PR rate in gemcitabine group(31.6%) is more superior than that in non-gemcitabine group. The incidence of bone marrow suppression and gastrointestinal reaction in non-gemcitabine group are33.3%and40%respectively. The incidence of gastrointestinal reaction in non-gemcitabine group is statistically higher than that in gemcitabine group.4) In gemcitabine group,32patients had finished their follo wing-up. The media time to following-up was3months,which ranged from1month to32months.Their media PFS is3months. In14patients who got CR or PR in gemcitabine group,13patients had finished following-up. The media time of DOR is7months.5) In gemcitabine group, the number of patients over60-years-old is18. In non-gemcitabine group, this number is4. In those over60-year-old patients, the ORR, CR, PR are50%,6%and44%in gemcitabine group, and are25%,25%,0%in non-gemcitabine group. No statistical difference between two groups was seen. The incidence of bone marrow suppression and gastrointestinal reaction are both11.1%in gemcitabine group, and are50%,75%respectively in non-gemcitabine group. There is statistical difference between two groups in the incidence of gastrointestinal reaction was seen.Conclusion:1) The PR of refractory or relapsed non-hodgkin lymphoma patients in our hospital who received chemotherapy contained gemcitabine is superior than other second-line chemoth-erapy without gemcitabine.2) The incidence of gastrointestinal reaction in patients who received chemotherapy contained gemcitabine is less than those who got other second-line chemotherapy without gemcitabine.3) there is no statistically difference of ORR, CR, PR between B-cell lymphoma patients and T-cell lymphoma patients who received chemotherapy contained gemcitabine.4) In patients over60-years-old, the ORR, CR, PR is not statistically different between patients received chemotherapy with or without gemcitabine. The incidence of gastrointestinal reaction in patients who received chemotherapy contained gemcitabine is less than those who got other second-line chemotherapy without gemcitabine. |
PDF Full Text Request