Yung L, Cunningham D, Hancock B, Smith P, Maclennan K, Linch D, McMillan A
Department of Haematology, University College London, UK.
Br J Cancer. 2004 Aug 16;91(4):695-8. doi: 10.1038/sj.bjc.6602031.
The optimal first-line treatment for symptomatic patients with advanced stage follicular lymphoma remains unclear. Fludarabine-based combination regimens have been extensively used in relapsed disease and merit consideration as first-line therapy. We here report the results of a phase II study of FAD (fludarabine, adriamycin, dexamethasone) regimen in 30 patients with advanced stage follicular lymphoma requiring treatment. The response rate was in excess of 90% with 39% achieving a complete remission. The major toxicity was myelosuppression, but only 3% of cycles were associated with grade IV leucopenia. The high response rate has not translated into major improvements in failure-free survival and consideration must be given to alternative treatment modalities to consolidate the high rate of initial responses.
对于晚期滤泡性淋巴瘤有症状的患者，最佳一线治疗方案仍不明确。基于氟达拉滨的联合方案已广泛用于复发性疾病，值得作为一线治疗方案考虑。我们在此报告一项针对30例需要治疗的晚期滤泡性淋巴瘤患者的FAD（氟达拉滨、阿霉素、地塞米松）方案II期研究的结果。缓解率超过90%，39%达到完全缓解。主要毒性是骨髓抑制，但仅3%的疗程与IV级白细胞减少有关。高缓解率并未转化为无进展生存期的显著改善，必须考虑采用替代治疗方式来巩固高初始缓解率。
