The Effect of Rituximab in Combination with MEVP Chemotherapy and rhG-CSF in Old Patients of Refractory and Terminal Non-Hodgkin’s Lymphoma.

It is very important and difficult to study and research the safety and effective methods of treatment in the Terminal or refractory Non-Hodgkin’s Lymphoma ( NHL)patients, especially old patients. To evaluate the safety and efficacy of Rituximab in Combination with MEVP Chemotherapy and rhG-CSF in old patients of Refractory and Terminal Non-Hodgkin’s Lymphoma, 4 old patients of Refractory and Terminal Non-Hodgkin’s Lymphoma( disease history about 6~8 years),3 females and 1 male, between 66~75 years of age (mean age 70.5 years), 2cases IVB, 1 cases IVA, 1case IIIA., Superficial and deep multiple lymph nodes enlarged obviously in all patients and 3 cases of them showed multiple lymph node enlargement and marked lumps in abdominal cavity, 2 cases of them with hydrothorax and ascites, 2 cases of them with bone marrow infiltration and heart disease, 1 case of them with multiple lumps in liver and another of them with autoimmune hemolytic anemia (AIHA), All patients had been treated with chemotherapy included COP (or COPP), CHOP, BCAOP (or BECAOP), MIV (or ESHAP) etc. and 2 patients of them had been treated by radiotherapy before they were treated by Rituximab Combination with MEVP Chemotherapy and rhG-CSF. In this experiment, they were treated by Rituximab plus MEVP Chemotherapy and rhG-CSF,( Rituximab 375 mg/m2/d1, Mitoxantrone 8~10mg/m2/d3, Wumon 0.1/d3~d5 (or VP16 O.1/d3~d7), Vinorelbinum 20mg/m2/d3, Prednison 60mg/d3~d9), rhG-CSF 100~300/d were injected when the number of WBC was <2.0×109/L after chemotherapy. Each cycle was 28~35days. The result is, the minimum of WBC after chemotherapy were 0.6~1.4×109/L, A patient of NHL with AIHA after a treating cycle achieved complete remission (CR), all of enlarged lymph nodes disappeared and Hemoglobin return to normal. Two of patients obtained part remission (PR), most of enlarged lymph nodes disappeared or reduced obviously and hydrothorax and ascites in patients disappeared. The treatment of one patient was inefficacious.

Our study result indicates: The therapy method of Rituximab in Combination with MEVP Chemotherapy and rhG-CSF for the most of patients of Refractory and Terminal Non-Hodgkin’s Lymphoma is safe and effective, no significant toxicity was found during treatment, this treatment method are suitable for most of patients of refractory and Terminal Non-Hodgkin’s Lymphoma and old patients of refractory and Terminal Non-Hodgkin’s Lymphoma.