Maloney David G
Fred Hutchinson Cancer Research Center, D1-100, 1100 Fairview Avenue, North Seattle, WA 98109-1024, USA.
Curr Hematol Rep. 2003 Jan;2(1):13-22.
Treatment with the chimeric anti-CD20 antibody rituximab has been rapidly accepted into the clinical treatment of patients with CD20 positive lymphoma. The low toxicity profile, relative ease of administration, and encouraging response rates observed as a single agent allow it to be used alone or in combination with or following standard chemotherapies. Patients with follicular non-Hodgkin's lymphoma (NHL) have a high response rate to treatment with this new modality, with overall response rates of 50% to 60% in the relapsed setting and 70% in the initial setting. The addition of scheduled retreatment or maintenance therapy leads to improved clinical responses and delays time to progression. Combination trials with chemotherapy demonstrate feasibility and promising response rates including clearing of minimal residual disease detected using molecular techniques. To date, there are limited randomized clinical trial data available to guide the use of this new modality in this patient population and few long-term results. It remains difficult to determine when and how to use this new modality best in the overall treatment course of these patients. This paper discusses the rationale for the use of rituximab in patients with follicular NHL and discusses the available data involving dosing, schedule, timing, and combinations with chemotherapy.
嵌合抗CD20抗体利妥昔单抗已迅速被应用于CD20阳性淋巴瘤患者的临床治疗中。其低毒性、相对易于给药以及作为单一药物观察到的令人鼓舞的缓解率，使其可单独使用，或与标准化疗联合使用或在标准化疗之后使用。滤泡性非霍奇金淋巴瘤（NHL）患者对这种新治疗方式的治疗反应率很高，复发患者的总体缓解率为50%至60%，初治患者为70%。定期再治疗或维持治疗可改善临床反应并延迟疾病进展时间。与化疗的联合试验证明了其可行性和有前景的缓解率，包括清除使用分子技术检测到的微小残留病。迄今为止，可用于指导在该患者群体中使用这种新治疗方式的随机临床试验数据有限，长期结果也很少。在这些患者的整体治疗过程中，仍然难以确定何时以及如何最佳地使用这种新治疗方式。本文讨论了在滤泡性NHL患者中使用利妥昔单抗的理论依据，并讨论了有关给药剂量、方案、时机以及与化疗联合使用的现有数据。
