改良SMILE方案治疗结外NK_T细胞淋巴瘤初探.pdf

· 1438· 徐小红，等 改 良SMILE方案治疗结外NK／T细胞淋巴瘤初探 改良SMILE方案治疗结外 NK／T细胞淋巴瘤初探 徐小红，杨 磊，谭清和，丛智荣，倪静怡，吴德祥 EffectsofmodifiedSMILEprotocolinthetreatmentofENKTL——NT XuXiaohong，YangLei，TanQinghe，CongZhirong，NiJingyi，WuDexiang DepartmentofInternalMedicine，AffiliatedTumorHospitalofNantongUniversity，JiangsuNantong226361，China． 【Abstract】 Objective：Todiscusstheshort—termefficacyandadverseeffectsofmodifiedSMILEregimeninthe treatmentofnasaltypeextranodalNK／T—celllymphoma．Methods：FromJune2009toMarch2012，7patientswith stagem andstage1VENKTL—NTwereinvolvedinthisstudy．Amongthem．4patientswererefractoryand3patients werenewlydiagnosed．AllpatientsweretreatedwithmodifiedSMILEprotocol(Methylprednisolone80mg，iv，d2～5；If- osfamide(IFO)1．333g／m ，iv，d2—5，theUnitedStatesdepartmentofsodium(Mesna)300mg／m ，iv，drug0，4and 8h，etoposide(Vp一16)75mg／m ，iv，d2—5；Culturedoorwinterenzyme(Pegasparaginase)2500IU／m ，im，d1；Meth- otrexate(MTX)1．0g／m ，iv，6h)．Results：All7patientsreceivedatotalofSMILEregimenfor31cycles．eachcase atleasttwocycles，Amongthe7patients，5patientsachievedcompleteremission，1patientachievedpartialremission and1patientwasprogressing．Theoverallresponsewas85．7％ ，completeresponseratewas71．4％ ．Amongthem ， gradeⅢ 一1V leucopeniawasobservedin11cycles．gradeⅢ 一1V hemoglobindecreasedwasobservedin3cycles， grade11I—IV thromboeytopeniawasobservedin6cycles，gradem liverdysfunctionwasobservedin4cycles．Con- clusion：ModifiedSMILEregimenisaneffectivetreatmentregimenofrnewlydiagnosed，refractory patientswithENK— TL—NT． 【Keywords】extrnaodalNK／T—celllymphoma；nasaltype；chemotherapy；L—Asparaginase；pegasparagase ModemOneology2014，22(06)：1438—1440 【摘要】 目的：观察改良SMILE方案治疗结外NK／T细胞淋巴瘤的近期疗效和安全性。方法：2009年6月至 2012年3月收治的7例Ⅲ一Ⅳ期患者，3例为初治，4例为复发、难治性患者，均采用改良SMLIE(甲基强的松 龙 80mg，iv，d2—5；异环磷酰胺 (IFO)1．333g／