国际肿瘤学杂志

国际肿瘤学杂志 ›› 2017, Vol. 44 ›› Issue (2): 104-107.doi: 10.3760/cma.j.issn.1673422X.2017.02.006

• 论著 • 上一篇    下一篇

培门冬酶和左旋门冬酰胺酶治疗NK/T细胞淋巴瘤的疗效和安全性

张克,于晓丽,韩春山   

  1. 266011 青岛市商业职工医院肿瘤科
  • 出版日期:2017-02-08 发布日期:2017-01-04
  • 通讯作者: 张克，Email: zhangke001_2005@163.com E-mail:zhangke001_2005@163.com

Efficacy and safety of pegaspargase and L-asparaginase in the treatment of NK/T-cell lymphoma

Zhang Ke, Yu Xiaoli, Han Chunshan   

  1. Department of Oncology, Hospital of Qingdao Commercial Staff, Qingdao 266011, China
  • Online:2017-02-08 Published:2017-01-04
  • Contact: Zhang Ke E-mail:zhangke001_2005@163.com

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摘要： 目的观察比较培门冬酶（PEG-ASP）与左旋门冬酰胺酶（L-ASP）治疗NK/T细胞淋巴瘤的临床疗效及不良反应。方法回顾性分析2009年9月—2015年7月青岛市商业职工医院肿瘤科收治的结外NK/T细胞淋巴瘤患者46例，其中24例采用PEGASP联合GDP方案（吉西他滨+顺铂+地塞米松）治疗的为PEG-ASP组，22例采用L-ASP联合GDP方案治疗的为L-ASP组，观察两组患者的疗效及不良反应。结果PEG-ASP组CR 11例，PR7例，完全缓解率和客观缓解率分别为45.83%和75.00%；L-ASP组CR 9例，PR 6例，完全缓解率和客观缓解率分别为40.91%和68.18%；两组患者客观缓解率的差异无统计学意义（χ2=0.263，P=0.608)。不良反应主要以1~2度为主，PEGASP组和LASP组患者骨髓抑制（25.00%∶22.73%，χ2=0.033，P=0.857）、凝血异常（8.33%∶9.10%，χ2=0.008，P=0.927）、肝肾功能异常（8.33%∶18.18%，χ2=0.982，P=0.322）、胃肠道反应（41.67%∶40.91%，χ2=0.003，P=0.958）的发生率差异无统计学意义；PEGASP组过敏反应发生率明显低于L-ASP组（4.17%∶36.36%），差异有统计学意义（χ2=7.561，P=0.006）。PEGASP组患者平均住院时间为（10.04±1.63）d，LASP组为（13.09±2.76）d，差异有统计学意义（t=-4.612，P=0.000）。结论PEGASP与LASP联合化疗治疗NK/T细胞淋巴瘤疗效相当，但PEGASP过敏反应少，患者住院时间缩短，值得临床进一步推广应用。

关键词: 淋巴瘤, 结外NK-T细胞, 天冬酰胺酶, 治疗结果, 药物毒性, 培门冬酶

Abstract: Objective  To compare the clinical efficacy and adverse effects of pegaspargase (PEG-ASP) and L-asparaginase (L-ASP) in the treatment of NK/T-cell lymphoma. Methods  A retrospective analysis was conducted on the clinical data of 46 patients with NK/T-cell lymphoma in Department of Oncology of Hospital of Qingdao Commercial Staff from September 2009 to July 2015. There were 24 patients treated by PEG-ASP combined with GDP (gemcitabine+cisplatin+dexamethasone) as PEG-ASP group, and 22 patients treated by L-ASP combined with GDP as L-ASP group. The efficacy and adverse reactions were compared between the two groups. Results  In the PEG-ASP group, there were 11 patients with complete remission, 7 patients with partial remission, and the complete remission rate and objective response rate were 45.83% and 75.00%. In the L-ASP group, there were 9 patients with complete remission, 6 patients with partial remission, and the complete remission rate and objective response rate were 40.91% and 68.18%. There was no significant difference between the two groups in objective response rate (χ2=0.263, P=0.608). Adverse effects such as myelosuppression (25.00% vs. 22.73%, χ2=0.033, P=0.857), coagulopathy (8.33% vs. 9.10%, χ2=0.008, P=0.927), liver and renal dysfunction (8.33% vs. 18.18%, χ2=0.982, P=0.322), gastrointestinal reaction (41.67% vs. 40.91%, χ2=0.003, P=0.958) were similar in the PEG-ASP group and L-ASP group. But the risk of allergic reaction incurred by PEG-ASP was much lower than L-ASP (4.17% vs. 36.36%), with a significant difference (χ2=7.561, P=0.006). Moreover, the PEG-ASP group had a shorter duration of hospitalization ［(10.04±1.63)d］ than the L-ASP group ［(13.09±2.76)d］, with a significant difference (t=-4.612, P=0.000). Conclusion  The efficacy of PEG-ASP and L-ASP in the treatment of NK/Tcell lymphoma is similar, but the rate of allergic reaction of patients treated with PEG-ASP is significantly lower, and the hospitalization time is significantly shorter, which is worthy of further clinical application.

Key words: Lymphoma, extranodal NKTcell; Asparaginase, Treatment outcome, Drug toxicity, Pegaspargase