使用泼尼松联合或不联合COPBLAM/IMVP-16方案治疗血管免疫母细胞性淋巴结病（AILD）型T细胞淋巴瘤。一项多中心研究。基尔淋巴瘤研究组。

Treatment of angioimmunoblastic lymphadenopathy (AILD)-type T-cell lymphoma using prednisone with or without the COPBLAM/IMVP-16 regimen. A multicenter study. Kiel Lymphoma Study Group.

作者信息

Siegert W, Agthe A, Griesser H, Schwerdtfeger R, Brittinger G, Engelhard M, Kuse R, Tiemann M, Lennert K, Huhn D

机构信息

Klinikum Rudolf Virchow, Freie Universität Berlin, Germany.

出版信息

Ann Intern Med. 1992 Sep 1;117(5):364-70. doi: 10.7326/0003-4819-117-5-364.

DOI:10.7326/0003-4819-117-5-364

PMID:1380221

Abstract

OBJECTIVE

To describe the clinical course of patients with angioimmunoblastic lymphadenopathy (AILD)-type lymphoma with a sequential treatment with prednisone and COPBLAM/IMVP-16.

DESIGN

A multicenter, prospective, nonrandomized trial.

SETTING

University medical centers and community hospitals.

PATIENTS

Sixty-seven patients were registered, 28 were excluded, and 39 patients were evaluable for response (median age, 59 years; range, 25 to 82 years) (stages I and II, 10%; stages III and IV, 90%; B symptoms, 74%).

MEASUREMENTS

Response, survival, and relapse.

INTERVENTION

Patients initially received prednisone and no further treatment if a complete remission was achieved. Relapsing or refractory patients were treated with COPBLAM/IMVP-16. Patients with life-threatening tumor progression or extension received COPBLAM/IMVP-16 initially. Treatments were chosen in accordance with tumor extension and response to prednisone. Treatment modalities were not compared.

RESULTS

Twenty-eight patients received primary prednisone, 18 received secondary prednisone, and 11 received primary chemotherapy. The complete response rates (with 95% CIs) were 29% (CI, 12% to 46%), 56% (CI, 33% to 79%), and 64% (CI, 36% to 92%), respectively. The median observation time of surviving patients was 28 months (range, 7 to 53). The median overall survival time was 15 months. The probabilities (with 95% CIs) of overall survival, event-free survival, and relapse at 36 months were 40.5% (CI, 24% to 56%), 32.3% (CI, 17% to 47%), and 34.6% (CI, 14% to 56%), respectively. At the time of evaluation, 22 of 39 patients had died, 7 of noninfectious complications and 14 of infections.

CONCLUSIONS

Prednisone with or without COPBLAM/IMVP-16 treatment in AILD-type lymphoma leads to complete remissions in about half of the patients and in long-term, disease-free survival for one third.

摘要

目的

描述血管免疫母细胞性淋巴结病（AILD）型淋巴瘤患者采用泼尼松序贯COPBLAM/IMVP - 16治疗的临床病程。

设计

一项多中心、前瞻性、非随机试验。

地点

大学医学中心和社区医院。

患者

登记患者67例，排除28例，39例患者可评估疗效（中位年龄59岁；范围25至82岁）（Ⅰ期和Ⅱ期占10%；Ⅲ期和Ⅳ期占90%；有B症状者占74%）。

测量指标

疗效、生存率和复发情况。

干预措施

患者最初接受泼尼松治疗，若达到完全缓解则不再接受进一步治疗。复发或难治性患者采用COPBLAM/IMVP - 16治疗。有危及生命的肿瘤进展或扩散的患者最初采用COPBLAM/IMVP - 16治疗。根据肿瘤扩散情况和对泼尼松的反应选择治疗方法。未比较治疗方式。

结果

28例患者接受初始泼尼松治疗，18例接受二次泼尼松治疗，11例接受初始化疗。完全缓解率（95%可信区间）分别为29%（可信区间，12%至46%）、56%（可信区间，33%至79%）和64%（可信区间，36%至92%）。存活患者的中位观察时间为28个月（范围7至53个月）。中位总生存时间为15个月。36个月时总生存、无事件生存和复发的概率（95%可信区间）分别为40.5%（可信区间，24%至56%）、32.3%（可信区间，17%至47%）和34.6%（可信区间，14%至56%）。在评估时，39例患者中有22例死亡，7例死于非感染性并发症，14例死于感染。