Pichert G, Schmitz S F, Hess U, Cerny T, Cogliatti S B, Betticher D, Stupp R, Schmitter D, Stahel R A, Ghielmini M
Division of Oncology, The Swiss Group for Clinical Cancer Research, University Hospital, Ramistrasse, Zurich, Switzerland.
Clin Lymphoma. 2001 Mar;1(4):293-7. doi: 10.3816/clm.2001.n.004.
Rituximab 375 mg/m(2) weekly x 4 has been reported to induce a 60% response rate in patients with relapsed follicular lymphomas (FL). Our aim was to examine the effect of this rituximab schedule on circulating FL cells in an ongoing multicenter study. One hundred fifty-four patients with FL were examined by nested polymerase chain reaction (PCR) at baseline for the presence of t(14;18) translocation-carrying lymphoma cells in bone marrow and/or blood. Sixty-four patients (42%) had PCR-detectable t(14;18)(+) FL cells. Pretreatment characteristics of these 64 patients were as follows: one had stage I, nine had stage II, 14 had stage III, and 40 had stage IV disease. Thirty-five patients had bulky disease (> or = 5 cm) and 25 patients had an elevated serum lactate dehydrogenase (LDH) level. Bone marrow was morphologically assessed in 64 patients, and 39 of these patients had an infiltration with FL cells. Blood samples from 51 patients were available for PCR analysis between weeks 8-12 after induction therapy, and 28 of these patients (55%) were PCR negative. Paired blood and bone marrow samples were available for PCR analysis from 39 patients between weeks 8-12 after induction therapy with rituximab. Thirteen of these patients (33%) did not have PCR-detectable cells in blood and bone marrow, while 26 patients (67%) still had circulating t(14;18)(+) cells in either bone marrow (eight patients), blood (one patient), or both (17 patients). PCR negativity in blood and bone marrow in 13 patients was statistically significantly associated with partial or complete response after induction therapy with rituximab (P = 0.006). However, clearance of PCR-detectable t(14;18)(+) cells in bone marrow and/or blood could not be associated with any low tumor burden pretreatment characteristics such as stages I/II, absence of morphological bone marrow infiltration or tumor bulk of > or = 5 cm, and normal serum LDH.
据报道，利妥昔单抗375mg/m²每周一次，共4周，可使复发滤泡性淋巴瘤（FL）患者的缓解率达到60%。在一项正在进行的多中心研究中，我们旨在研究这种利妥昔单抗给药方案对循环FL细胞的影响。154例FL患者在基线时通过巢式聚合酶链反应（PCR）检测骨髓和/或血液中携带t(14;18)易位的淋巴瘤细胞。64例患者（42%）的PCR检测到t(14;18)(+)FL细胞。这64例患者的预处理特征如下：1例为I期，9例为II期，14例为III期，40例为IV期疾病。35例患者有大包块病变（≥5cm），25例患者血清乳酸脱氢酶（LDH）水平升高。对64例患者进行了骨髓形态学评估，其中39例患者有FL细胞浸润。51例患者在诱导治疗后第8 - 12周的血样可用于PCR分析，其中28例患者（55%）PCR检测为阴性。39例患者在利妥昔单抗诱导治疗后第8 - 12周有配对的血样和骨髓样可用于PCR分析。其中13例患者（33%）在血液和骨髓中未检测到PCR可检测的细胞，而26例患者（67%）在骨髓（8例患者）、血液（1例患者）或两者（17例患者）中仍有循环t(14;18)(+)细胞。13例患者血液和骨髓中的PCR阴性与利妥昔单抗诱导治疗后的部分或完全缓解在统计学上显著相关（P = 0.006）。然而，骨髓和/或血液中PCR可检测的t(14;)(+)细胞的清除与任何低肿瘤负荷的预处理特征无关，如I/II期、无形态学骨髓浸润或肿瘤包块≥5cm以及血清LDH正常。
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