Efficacy and safety of Hyper-CVAD regimen for treatment of aggressive T-cell lymphoma
10.3760/cma.j.issn.1009-9921.2018.01.008
- VernacularTitle:Hyper-CVAD方案治疗侵袭性T细胞淋巴瘤的效果和安全性
- Author:
Huacong CAI
1
;
Jing CUI
;
Daobin ZHOU
;
Minghui DUAN
;
Tienan ZHU
;
Jian LI
;
Junling ZHUANG
;
Bing HAN
;
Wei ZHANG
Author Information
1. 100730,中国医学科学院 北京协和医学院 北京协和医院血液内科
- Keywords:
Lymphoma;
T-cell;
aggressive;
Antineoplastic combined chemotherapy protocols;
Efficacy;
Safety
- From:
Journal of Leukemia & Lymphoma
2018;27(1):28-32,36
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the safety and efficacy of Hyper-CVAD intensive chemotherapy regimen in patients with newly diagnosed aggressive T-cell lymphoma. Methods The efficacy, side effects and survival status were retrospectively analyzed in 34 patients with newly diagnosed aggressive T-cell lymphoma who received Hyper-CVAD regimen as induction therapy in Peking Union Medical College Hospital from September 2009 to December 2010. Results Of 34 patients, 28 cases (82.4 %) showed treatment response, including 10 cases (29.4 %) of complete response (CR). Eleven patients underwent stem cell transplantation, including 1 case of human leukocyte antigen-identical siblings allogeneic stem cell transplantation. The median follow-up was 16 months (1-82 months), and the overall survival (OS) rate of 1 or 3-year was 70.2 % and 41.1 % respectively, and progression-free survival (PFS) rate of 1 or 3-year was 49.3 % and 31.6 % respectively. The major adverse reaction was myelosuppresion, including 18 cases (52.9%) of myelosuppresion with grade Ⅳ. Three patients died of serious infection. Cox regression multifactor analysis showed CR was the only influencing factor for PFS (HR=6.118, 95%CI 1.327-28.206, P=0.020). Marrow involvement (HR= 0.270, 95 %CI 0.101-0.722, P= 0.009) and CR (HR= 6.669, 95 %CI 1.754-25.354, P= 0.005) were independent influencing factors for OS. Conclusions Hyper-CVAD regimen has a high response rate for aggressive T-cell lymphoma, but the lasting effectiveness and the short-term efficacy show unfavorable performances. Meanwhile, myelosuppression is serious and infection incidence is high. Autologous hematopoietic stem-cell transplantation after remission may improve the outcome.