Clinical curative effect of rhGM -CSF joint R -CHOP regimen in the treatment of diffuse large B cell lymphoma
10.3760/cma.j.issn.1008-6706.2016.06.002
- VernacularTitle:人粒细胞-巨噬细胞集落刺激因子联合R-CHOP方案治疗弥漫大B细胞淋巴瘤的临床疗效研究
- Author:
Yun ZHANG
;
Wenye HUANG
;
Jian ZHANG
;
Jianjia PAN
- Publication Type:Journal Article
- Keywords:
Diffuse large B-cell lymphoma;
rhGM-CSF;
Rituximab;
CHOP regimen
- From:
Chinese Journal of Primary Medicine and Pharmacy
2016;23(6):805-809
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the clinical curative effect of the recombinant human granulocyte-macro-phage colony-stimulating factor ( rhGM -CSF) joint R-CHOP regimen in the treatment of diffuse large B cell lymphoma (DLBCL).Methods 72 hospitalized patients with DLBCL were chosen from January 2014 to January 2015.The patients were randomly divided into joint CHOP rituxan group ( R-CHOP group,36 cases) and the joint treatment group (36 cases) .The R-CHOP group was treated by R-CHOP regimen,the joint group was given rhGM-CSF on the basis of R-CHOP treatment.Before chemotherapy and 15 days,1 month,3 months after chemotherapy, the peripheral blood was collected,and the monocytes were separated,flow cytometry was used to count HLA-DR, CD197 marked M1 cells and CD68,CDl63 marked M2 cells.4 months after chemotherapy,the curative effect was evaluated.Results 4 months after treatment,the ORR of joint group (91.67%) was significantly higher than that of R-CHOP group (75.00%),and the difference was statistically significant (χ2 =4.372,P<0.05).After treatment, the adverse reactions of joint group,the liver function injuryⅠ-Ⅱlevel 8.33%,Ⅲ-Ⅳlevel 0.00%;White blood cells reduceⅠ-Ⅱlevel 25.00%,Ⅲ-Ⅳ level 5.56%;Thrombocytopenia Ⅰ-Ⅱ level 19.44%,Ⅲ-Ⅳ level;8.33%;Nausea and vomitingⅠ-Ⅱ level 8.33%,Ⅲ-Ⅳ level 0.00%.The adverse reactions after treatment of R-CHOP group,the liver function injury Ⅰ-Ⅱ level 13.89%,grade Ⅲ-Ⅳ2.78%;White blood cells reduceⅠ-Ⅱlevel 36.11%,Ⅲ-Ⅳlevel 11.11%;ThrombocytopeniaⅠ-Ⅱlevel 33.33%,Ⅲ-Ⅳlevel 2.78%;Nau-sea and vomitingⅠ-Ⅱ level 13.89%,Ⅲ-Ⅳ level 0.00%.The increased ratio of TAM quantity in combined treatment group (63.89%) was significantly more than R-CHOP group (38.89%),the difference was statistically significant (χ2 =7.938,P <0.05).In joint group,the positive expression rates of CD68 (46.11%),IL -6 (44.44%),IL-8 (58.33%) were significantly higher than those of R-CHOP group[CD68 (13.89%),IL-6 (19.44%),IL-8 (38.89%)],the differences were statistically significant (χ2 =3.278,3.278,4.489,all P<0.05).Conclusion R-CHOP joint rhGM -CSF has better curative effect than R-CHOP plan and less adverse reaction,and under the induction of rhGM -CSF,mononuclear cells can develop into M1 macrophages,in DLBCL microenvironment,to induce TAM to M1 M2 type in reverse polarization,improve the microenvironment of DLBCL and provide chance for cure of DLBCL.
