Raderer Markus, Wöhrer Stefan, Bartsch Rupert, Prager Gerald, Drach Johannes, Hejna Michael, Gaiger Alexander, Turetschek Karl, Jaeger Ulrich, Streubel Berthold, Zielinski Christoph C
Department of Medicine I, University of Vienna, Vienna, Austria.
J Clin Oncol. 2005 Nov 20;23(33):8442-6. doi: 10.1200/JCO.2004.00.8532.
Various chemotherapeutic regimens have been applied for treatment of mucosa-associated lymphoid tissue (MALT) lymphoma, but no standard regimen has been identified to date. In view of the activity of oxaliplatin (L-OHP) in various types of lymphoma, we performed a phase II study to evaluate the activity of L-OHP for treatment of MALT lymphoma. The primary objective of this study was to determine the objective response rate according to WHO standard criteria.
A total of 16 patients with MALT lymphoma of various sites of origin (four of the ocular adnexa, five of the salivary glands, three of the stomach, two of the lung, and one of the colon and the breast) were administered L-OHP at a dose of 130 mg/m2 infused during 2 hours every 3 weeks. Restaging was performed every two cycles; treatment was continued until complete remission (CR) or for a maximum of six cycles in responders.
Sixty-five cycles were administered (median, four; range, two to six); toxicity consisted of transient sensory neuropathy in eight patients and nausea/emesis WHO grade 2 in two patients, whereas hematologic adverse effects (thrombocytopenia and leukocytopenia grade 2) occurred in only one patient each. Fifteen patients responded to chemotherapy, with nine achieving CR (56%), six (37.5%) achieving partial response, and one achieving stable disease; the median time to response was 4 months (range; 2 to 4 months).
These data suggest L-OHP is a highly active agent for treatment of MALT lymphoma. However, a longer follow-up is needed to judge whether these remissions are durable.
多种化疗方案已应用于黏膜相关淋巴组织(MALT)淋巴瘤的治疗,但迄今为止尚未确定标准方案。鉴于奥沙利铂(L-OHP)在各类淋巴瘤中的活性,我们开展了一项II期研究,以评估L-OHP治疗MALT淋巴瘤的活性。本研究的主要目的是根据世界卫生组织标准确定客观缓解率。
共有16例不同原发部位的MALT淋巴瘤患者(眼附属器4例、唾液腺5例、胃3例、肺2例、结肠和乳腺各1例)接受L-OHP治疗,剂量为130mg/m²,每3周静脉滴注2小时。每两个周期进行一次重新分期;治疗持续至完全缓解(CR),或对有反应者最多进行6个周期的治疗。
共进行了65个周期的治疗(中位数为4个周期;范围为2至6个周期);毒性反应包括8例患者出现短暂性感觉神经病变,2例患者出现WHO 2级恶心/呕吐,而血液学不良反应(2级血小板减少和白细胞减少)各仅发生在1例患者中。15例患者对化疗有反应,9例达到CR(56%),6例(37.5%)达到部分缓解,1例病情稳定;中位缓解时间为4个月(范围为2至4个月)。
这些数据表明L-OHP是治疗MALT淋巴瘤的一种高效活性药物。然而,需要更长时间的随访来判断这些缓解是否持久。