Wollina U, Hohaus K, Schönlebe J, Haroske E, Köstler E
Department of Dermatology, Krankenhaus Dresden-Friedrichstadt, Friedrichstrasse 41, 01067, Dresden, Germany.
J Cancer Res Clin Oncol. 2003 Jan;129(1):65-9. doi: 10.1007/s00432-002-0403-9. Epub 2003 Jan 22.
PURPOSE: Advanced cutaneous T-cell lymphoma (CTCL) is a hard-to-treat condition. Complete response is rare even with polychemotherapy. The use of liposomal formulation anti-cancer drugs can improve the efficacy and the risk-benefit ratio. Liposomal doxorubicin was shown to be effective as a second-line treatment in CTCL. There is no data available on another classical anthracycline, daunorubicin, when given in liposomal formulation as a monotherapy. METHODS: Monotherapy with liposomal-encapsulated daunorubicin (DNX) was given as a monotherapy once a month at 20 mg/m(2) three times to achieve a clinical response. In the case of limited response the drug was given once every 3 weeks and a dose increase was performed. Three patients were treated. RESULTS: A complete response was achieved in one patient (dosage 20 mg/m(2 )once per month). Two other patients achieved a partial response. The final outcome was disease-free survival of more than 10 months in the patient with a complete response and survival of >8 months and 6 months in those with a partial response. Adverse effects were grade 4 anemia in one patient, lymphopenia grade 2 with grade 1 anemia, and grade 1 lymphopenia in the other patients. CONCLUSION: This is the first report on DNX monotherapy in CTCL. In a small group of three patients a response rate of 100% was achieved with one complete response. DNX seems to be another option in advanced cases of CTCL.
目的:晚期皮肤T细胞淋巴瘤(CTCL)是一种难以治疗的疾病。即使采用多药化疗,完全缓解也很罕见。使用脂质体制剂的抗癌药物可以提高疗效和风险效益比。脂质体阿霉素已被证明作为CTCL的二线治疗有效。关于另一种经典蒽环类药物柔红霉素以脂质体制剂单药使用时,尚无可用数据。 方法:采用脂质体包裹的柔红霉素(DNX)单药治疗,每月一次,剂量为20mg/m² ,共给药三次以获得临床反应。若反应有限,则每3周给药一次并增加剂量。共治疗了3例患者。 结果:1例患者获得完全缓解(剂量为每月20mg/m²一次)。另外2例患者获得部分缓解。最终结果是,完全缓解的患者无病生存期超过10个月,部分缓解的患者生存期分别>8个月和6个月。不良反应方面,1例患者出现4级贫血;1例患者出现2级淋巴细胞减少伴1级贫血;其他患者出现1级淋巴细胞减少。 结论:这是关于DNX单药治疗CTCL的首份报告。在3例患者组成的小样本中,完全缓解1例,总有效率达100%。DNX似乎是晚期CTCL病例的另一种选择。
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