恶性淋巴瘤分类及进展概说PPT.ppt

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2018-01-24 发布于江苏
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恶性淋巴瘤分类及进展概说PPT.ppt

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恶性淋巴瘤分类及进展概说PPT

CHOP q2w vs q3w Conclusion Intensified CHOP with the support of G-CSF may be beneficial for M-H/H risk DLCL patients APSCT With BEAC Intensive Chemotherapy for Refractory and Relapsed lymphoma patients 最佳选择：CR2 / Relpse1IPI Hi Risk：CR1 ? BEAC BCNU 300mg/2 Etoposide 1200mg/m2 Ara-C 1500-2000mg/m2 CTX 3600~4000mg/m2 ASC reinfused 24~48h following completion of Chemo Results All patients obtained prompt and sustained hematopoietic reconstitution 1 year Survival 61.2% 2 year Survival 53.4% 3 year Survival 53.4% Salvage therapy of DLCL Which Regime is best choice: IMVP-16 DHAP ESHAP Only Brief Response DICE EPOCH 5d cont. inf. Better Response and Tolerability? DHAP for Refractory or Relapsed DLCL #27 CR 8, PR 4, RR 44.4% MST 8.3m, 1ys 30.8% , 2ys 19.3% MRP 4.8m G3/4 Neutropenia 15 (57.7%) G3/4 Thrombocytopenia 21 (80.6%) EPOCH for Refractory or Relapsed DLCL n=21 (B 14 T 7) CR 4 PR 5 Overall RR 9/21=42.6% B cell RR 50.0% T cell RR 28.6% G3/4 Toxicity Neutropenia 30.1% Febrilneutropenia 11.1% Thrombocytopenia 8.3% Cardiovascular 0 R-TT Salvage Therapy Rituximab 375mg/m2 d1 Paclitaxel 200mg/m2 3hr inf d1 Topotecan 1mg/m2 30min inf d1~15 GCSF d6~16 R-TT Salvage TherapyMDACC experience Reap Rate% Clinical trial N Refractory Relapsed Taxol 44 15% 50% Topotecan 40 12% 43% T-T 63 31%(6%) 62 (18) % R-TT 45 55(25)% 80(60)% R-ICE in Relapsed/Refractory B-DLCL Reap Rate Clinical trial N Refractory Relapsed ICE 161 46(16)% 85(35)% R-ICE 35 57(31)% 96(70)% DLCL Sensitive Relapse(#109) A. Hi Dose chemo+ABMT (#55) median Follow Up 83个月缓解率 83.