Leonard John P, Furman Richard R, Ruan Jia, Coleman Morton
Center for Lymphoma and Myeloma, Division of Hematology and Medical Oncology, Weill Medical College of Cornell University and New York Presbyterian Hospital, New York, NY 10021, USA.
Curr Oncol Rep. 2005 Sep;7(5):364-71. doi: 10.1007/s11912-005-0063-4.
The clinical development of immunotherapy with rituximab (chimeric anti-CD20 monoclonal antibody) has markedly affected the treatment approach for patients with B-cell non-Hodgkin's lymphoma (NHL). Rituximab was initially evaluated in relapsed indolent lymphoma and has substantial activity in this setting both alone and in combination with chemotherapy. Ongoing efforts in indolent NHL are seeking to optimize the dose and schedule of rituximab through "maintenance" strategies exploring chemotherapy-rituximab combinations and the use of other biologic agents or antibodies that may enhance activity when employed together with rituximab. Other studies in indolent NHL suggest that radiolabeled anti-CD20 antibodies (such as I-131 tositumomab and Y-90 ibritumomab tiuxetan) may be useful in relapsed and refractory disease and have potential utility as part of initial treatment as well. In diffuse large B-cell lymphoma, the addition of rituximab to CHOP chemotherapy can improve survival, though benefits are more limited in mantle cell lymphoma. Further studies of unlabeled and radiolabeled immunotherapies are ongoing in order to optimize their use for maximal clinical benefit.
利妥昔单抗（嵌合抗CD20单克隆抗体）免疫疗法的临床进展显著影响了B细胞非霍奇金淋巴瘤（NHL）患者的治疗方法。利妥昔单抗最初在复发性惰性淋巴瘤中进行评估，在这种情况下，单独使用或与化疗联合使用均具有显著活性。惰性NHL正在进行的研究致力于通过“维持”策略优化利妥昔单抗的剂量和给药方案，探索化疗-利妥昔单抗联合方案以及使用其他生物制剂或抗体，这些制剂或抗体与利妥昔单抗联合使用时可能增强活性。惰性NHL的其他研究表明，放射性标记的抗CD20抗体（如I-131托西莫单抗和Y-90 替伊莫单抗）可能对复发性和难治性疾病有用，并且作为初始治疗的一部分也具有潜在效用。在弥漫性大B细胞淋巴瘤中，在CHOP化疗中添加利妥昔单抗可提高生存率，尽管在套细胞淋巴瘤中的益处更为有限。正在对未标记和放射性标记的免疫疗法进行进一步研究，以优化其使用，实现最大临床获益。
