Kết quả điều trị u lympho không Hodgkin tế bào B lớn lan tỏa thể thần kinh trung ương nguyên phát bằng R-Methotrexate liều cao tại Viện Huyết học - Truyền máu Trung ương giai đoạn 2019 – 2023=Treatment results of diffuse large B-cell non-Hodgkin lymphoma with primary central nervous system involvement using high-dose R-Methotrexate at the National Institute of Hematology and Blood Transfusion 2019

Kết quả điều trị u lympho không Hodgkin tế bào B lớn lan tỏa thể thần kinh trung ương nguyên phát bằng R-Methotrexate liều cao tại Viện Huyết học - Truyền máu Trung ương giai đoạn 2019 – 2023=Treatment results of diffuse large B-cell non-Hodgkin lymphoma with primary central nervous system involvement using high-dose R-Methotrexate at the National Institute of Hematology and Blood Transfusion 2019 - 2023

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Thị Nhung Hoàng, Quang Chiêm Lê, Thị Thắm Lê, Lan Phương Nguyễn, Hải Yến Phạm, Thị Vân Quỳnh Trần, Thị Thanh Bình Võ, Đức Bình Vũ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.83-93

Bộ sưu tập: Báo, Tạp chí

ID: 478217

Thêm vào giỏ

Đánh giá kết quả điều trị u lympho không Hodgkin tế bào B lớn lan tỏa thể thần kinh trung ương nguyên phát b ằng RMethotrexate liều cao và mối liên quan giữa các yếu tố tiên lượng với thời gian sống thêm. Đối tượng và phương pháp nghiên cứu: 64 bệnh nhân được chẩn đoán U lympho không Hodgkin tế bào B lớn lan tỏa CD20+ thể thần kinh trung ương nguyên phát điều trị bằng phác đồ methotrexate liều cao (HD-MTX 8g/m2) phối hợp Rituximab tại viện Huyết học - Truyền máu Trung ương từ T1/2019 đến T12/2023. Kết quả: Nghiên cứu thực hiện trên 64 BN với độ tuổi trung bình là 54,9, đa số BN dưới 60 tuổi. Tỷ lệ đáp ứng chung sau 3 và 6 chu kỳ điều trị lần lượt là 70,3% và 88,3%. Nhóm BN dưới 60 tuổi có tỷ lệ đáp ứng chung cao hơn nhóm BN trên 60 tuổi. Nhóm BN có BCL2 dương tính có tỷ lệ đáp ứng chung thấp hơn nhóm BCL2 âm tính. Tác dụng không mong muốn trên lâm sàng thường gặp buồn nôn/nôn 85,9% (độ 1-2), mệt mỏi 51,6%, chán ăn 53,1%, tổn thương niêm mạc 15,6%. Độc tính huyết học hay gặp nhất là giảm Hb và BCTT, giảm TC chỉ gặp tỷ lệ nhỏ, chủ yếu giảm độ 1 và độ 2. Độc tính ngoài huyết học gặp tăng GOT/GPT (42,2%), tăng creatinine (18,8%). Tỷ lệ OS tại thời điểm 24 tháng là 75,5%, 36 tháng là 60,9%. OS ước tính là 45,45 ± 3,76 tháng. Tỷ lệ PFS tại thời điểm 24 tháng là 62,5%, 36 tháng là 45,2%. PFS ước tính là 22,80 ± 3,55 tháng. Nhóm BN có chỉ số B2M tăng, tuổi >
60, có dấu ấn BCL2 dương tính và có biểu hiện 2 dấu ấn/3 dấu ấn (BCL2, BCL6, MYC) trên hóa mô miễn dịch có thời gian OS và PFS thấp hơn đáng kể so với nhóm BN còn lại.To evaluate the treatment outcomes of non-Hodgkin's lymphoma with diffuse large B-cell involvement of the central nervous system using high-dose R-Methotrexate chemotherapy and its correlation with prognostic factors. Subjects and method: 64 patients diagnosed with diffuse large B-cell non-Hodgkin's lymphoma with central nervous system (CNS) involvement, treated with high-dose Methotrexate chemotherapy (HD-MTX 8g/m2) combined with Rituximab at the Institute of Hematology and Blood Transfusion from December 2019 to December 2023. Results: Study conducted on 64 patients with an average age of 54.9 years, with the majority being under 60 years of age. The overall response rate after 3 treatment cycles was 70.3%
after 6 cycles, it was 88.3%. Patients under 60 years of age had a higher overall response rate than those over 60. Patients with positive BCL2 expression had a lower overall response rate compared to those with negative BCL2 expression. Common clinical adverse effects included nausea/vomiting in 85.9% (grade 1-2), fatigue in 51.6%, loss of appetite in 53.1%, and mucosal damage in 15.6%. The most common hematological toxicities were anemia and neutropenia, while thrombocytopenia was observed at a lower rate, mostly at grades 1 and 2. Non-hematological toxicities included elevated GOT/GPT (42.2%) and increased creatinine levels (18.8%). The overall survival (OS) rate at 24 months was 75.5%, and at 36 months it was 60.9%. The estimated OS was 45.45 ± 3.76 months. The progression-free survival (PFS) rate at 24 months was 62.5%, and at 36 months it was 45.2%. The estimated PFS was 22.80 ± 3.55 months. Patients with elevated B2M, age >
60 years, multiple tumors, positive BCL2 expression, and double-expressor/tripleexpressor status on immunohistochemistry had significantly lower OS and PFS compared to the remaining patients.

1. Đọc trực tuyến

1. Đọc trực tuyến

Tạo bộ sưu tập với mã QR