Abstract:

Objective　To investigate the effect of thalidomide combined with CHOP chemotherapy regimen on the immune function in patients with B-cell non-Hodgkin lymphoma. Methods　From June 2018 to June 2021, a total of 86 patients with B-cell non-Hodgkin lymphoma who received first-line chemotherapy in The Second People's Hospital of Liaocheng were selected and were divided into two groups by the random number table method. In the control group, there were 21 males and 22 females, ranging in age from 16 to 55 years old, with a median age of 32.7 years old. In the combined group, there were 22 males and 21 females, ranging in age from 16 to 58 years old, with a median age of 33.6 years old. The control group received CHOP chemotherapy regimen [vincristine (1.4 mg/m² d1) + epirubicin (50 mg/m² d1) + cyclophosphamide (750 mg/m² d1) + prednisone (100 mg qd d1-5)], and the combined group was given thalidomide (100 mg/d) on the basis of CHOP chemotherapy regimen, 21 days as 1 treatment cycle. The short-term curative effects, immune function [CD₃⁺ and immunoglobulin G (IgG)], and incidences of adverse reactions of the two groups were compared. t test and χ² test were used for statistical analysis. Results　In the control group, there were 13 cases of complete response, 8 cases of partial response, and 22 cases of no response; in the combined group, there were 22 cases of complete response, 8 cases of partial response, and 13 cases of no response. The effective rate of the combined group was 69.77% (30/43), which was higher than that of the control group [48.44% (21/43)] (χ²=4.900, P=0.027). There were no statistically significant differences in the levels of CD₃⁺ and IgG between the two groups before treatment (t=0.240 and 0.146, P=0.811 and 0.884). After treatment, the levels of CD₃⁺ and IgG in the two groups were higher than those before treatment (all P<0.05), and the levels of CD₃⁺ and IgG in the combined group were higher than those in the control group (t=2.131 and 11.939, P=0.036 and <0.001). The total incidence of adverse reactions was 18.60% (8/43) in the combined group and 16.28% (7/43) in the control group, with no statistically significant difference (χ²=0.081, P=0.776). Conclusion　Thalidomide combined with CHOP chemotherapy regimen can improve the clinical efficacy and immune function in patients with B-cell non-Hodgkin lymphoma, and it is safe and worthy of promotion.

Key words:

B-cell non-Hodgkin lymphoma, Thalidomide, CHOP chemotherapy regimen, Hair loss, Liver and kidney function injury, Security

摘要：

目的　探讨沙利度胺联合CHOP化疗方案对B细胞非霍奇金淋巴瘤患者免疫功能的影响。方法　选取2018年6月至2021年6月期间在聊城市第二人民医院行一线化疗的B细胞非霍奇金淋巴瘤患者共86例。按照随机数字表法分为对照组和研究组，对照组43例中男21例，女22例，年龄范围16～55岁，中位年龄32.7岁；联合组43例中男22例，女21例，年龄范围16～58岁，中位年龄33.6岁。对照组接受CHOP化疗方案［长春新碱（1.4 mg/m² d1）+表柔比星（50 mg/m² d1）+环磷酰胺（750 mg/m² d1）+泼尼松（100 mg qd d1～5）］；联合组在CHOP化疗方案的基础上另给予沙利度胺（100 mg/d）治疗，21 d为１个治疗周期。对比两组患者近期疗效、免疫功能水平［CD₃⁺、免疫球蛋白G（IgG）］、不良反应发生率。统计学方法采用t检验、χ²检验。结果　对照组患者完全缓解13例、部分缓解8例、未缓解22例；联合组完全缓解22例、部分缓解8例、未缓解13例；联合组治疗有效率为69.77%（30/43），高于对照组的48.44%（21/43）（χ²=4.900，P=0.027）。两组患者治疗前CD₃⁺、IgG水平比较差异均无统计学意义（t=0.240、0.146，P=0.811、0.884）；治疗后，两组CD₃⁺、IgG水平均高于同组治疗前（均P<0.05），且联合组的CD₃⁺、IgG水平均高于对照组（t=2.131、11.939，P=0.036、<0.001）。联合组治疗期间不良反应总发生率为18.60%（8/43），对照组为16.28%（7/43），差异无统计学意义（χ²=0.081，P=0.776）。结论　B细胞非霍奇金淋巴瘤患者采用沙利度胺联合CHOP化疗方案治疗可提高临床疗效，改善免疫功能，且安全性良好，值得推广。

关键词:

B细胞非霍奇金淋巴瘤, 沙利度胺, CHOP化疗方案, 脱发, 肝肾功能损伤, 安全性