Objective: To investigate the efficacy and safety of bendamustine combined with gemcitabine, vinorelbine，glucocorticoids (BeGEV)±X regimen in treatment of patients with relapsed/refractory non-Hodgkin lymphoma.
Methods: A total of 18 relapsed/ refractory non-Hodgkin lymphoma patients at the age of 18 years or older hospitalized in the First People's Hospital of Changzhou from March 2020 to March 2021 were selected. They received two or more cycles of BeGEV±X regimen. X could be anti-CD20 monoclonal antibody, PD-1-blocking antibodies, lenalidomide, BTK inhibitor, Bcl-2 inhibitor and so on according to patients' disease feature. The clinical efficacy and adverse effects were observed.
Results: In total, 18 patients completed two or more cycles of BeGEV±X regimen, including 14 with diffuse large B-cell lymphoma, one with low-grade follicular lymphoma, one with follicular lymphoma grade 3b, one with angioimmunoblastic T-cell lymphoma and one with peripheral T-cell lymphoma, not otherwise specified. 11 patients were male. The median age of the patients was 64 years old. 17 patients had modified Ann Arbor stage Ⅲ/Ⅳ disease. 13 patients had high- intermediate risk or high risk IPI score, while 15 patients had high-intermediate high risk or high risk NCCN-IPI score. 14 cases had extranodal sites of disease. And 6 cases had bulky disease. 12 patients experienced refractory disease, while 8 patients had received 3 line or more prior treatment. After two or three cycles of chemotherapy, the complete response rate was 6/18, the partial response rate was 3/18, and the objective response rate was 9/18. From the beginning of salvage chemotherapy to the end of follow-up, the median progression-free survival time was 130 days, and the median overall survival was 152 days. The most common grade 3 to 4 adverse events were hematologic toxicities, infection and febrile neutropenia.
Conclusion: BeGEV±X is an effective salvage regimen in treatment of patients with relapsed/refractory non-Hodgkin lymphoma, while adverse events such as hematologic toxicities and infection should be closely monitored.
题目: 苯达莫司汀联合方案治疗复发难治性非霍奇金淋巴瘤患者的疗效分析.
目的: 探讨苯达莫司汀联合吉西他滨、长春瑞滨、激素（BeGEV）±X方案治疗复发难治性非霍奇金淋巴瘤患者的疗效及安全性.
方法: 选取2020年3月至2021年3月常州市第一人民医院收治的18例年龄≥18岁复发难治性非霍奇金淋巴瘤患者，予BeGEV±X方案化疗，X根据患者疾病特征选用CD20单抗、PD-1抑制剂、来那度胺、BTK抑制剂、Bcl-2抑制剂等，观察临床疗效及毒副反应.
结果: 共18例患者完成≥2疗程BeGEV±X方案化疗，其中弥漫大B细胞淋巴瘤14例，低级别滤泡性淋巴瘤患者1例，滤泡性淋巴瘤3b级患者1例，血管免疫母细胞性T细胞淋巴瘤1例，外周T细胞性淋巴瘤-非特指型1例。18例患者的中位年龄为64岁，11例男性，改良Ann Arbor分期Ⅲ/Ⅳ期为17例，IPI评分高中危及高危组13例，NCCN-IPI评分高中危及高危组15例，14例患者存在结外病变，6例患者存在大包块。12例患者为难治性淋巴瘤，8例患者既往经过3线及以上的治疗。2-3个疗程后进行疗效评估，完全缓解（CR）率为6/18，部分缓解（PR）率为3/18，总体缓解率（ORR）为9/18。从BeGEV挽救性化疗开始至随访截止，中位疾病无进展生存（PFS）时间为130 d，中位总生存（OS）时间为152 d。最常见的3/4级不良反应为血液学毒性、感染、中性粒细胞减少伴发热.
结论: 苯达莫司汀联合吉西他滨、长春瑞滨、激素±X治疗复发难治性非霍奇金淋巴瘤具较好的疗效，治疗后需严密观察血液学毒性及感染等副反应.
Keywords: bendamustine; diffuse large B-cell lymphoma; gemcitabine; non-Hodgkin lymphoma; relapsed/refractory.