Wu Hong-Ju, Zhang Qing-Yuan, Chen De-Fa, Guan Xiao-Jun, Zhang Bo-Long, Ma Jun
Department of Medicine, Harbin Institute of Hematology and Oncology, Harbin, Heilongjiang 150010, P. R. China.
Ai Zheng. 2005 Dec;24(12):1498-502.
BACKGROUND & OBJECTIVE: CHOP regimen is the standard treatment for patients with diffuse large B-cell lymphoma. Rituximab, an anti-CD20 monoclonal antibody, is effective in treating diffuse large B-cell lymphoma. This study was conducted to compare the efficacy of rituximab plus CHOP and CHOP alone on newly diagnosed patients with diffuse large B-cell lymphoma, and analyze their toxicities.
A total of 72 newly diagnosed patients with diffuse large B-cell lymphoma were divided into 2 groups prospectively with concurrent control: 34 received CHOP plus rituximab (375 mg/m2, 2 days before each course) (combination group), 38 received CHOP alone. Each course lasted 3 weeks. All cases were evaluated after 6 courses.
The total response rate in combination group was 93.8% (30/32), among which complete remission was seen in 23 patients and partial remission was seen in 7 patientsû while the total response rate in CHOP group was 75.0% (27/36), among which complete remission was seen in 19 patients and partial remission was seen in 8 patients. The therapeutic efficacy was significantly better in combination group than in CHOP group (P<0.05). The 1-year progression-freely and overall survival rates were significantly higher in combination group than in CHOP group (81.2% vs. 52.8%, 93.8% vs. 75.0%, P<0.05). The major adverse events in combination group were infusion-related response which could be well tolerated, and hematological toxicities which were similar to those in CHOP group.
Rituximab increases the therapeutic efficacy of CHOP regimen on newly diagnosed patients with diffuse large B-cell lymphoma, without a clinically significant increase in toxicity. Rituximab plus CHOP can be used as a first-line therapy of diffuse large B-cell lymphoma.
CHOP方案是弥漫性大B细胞淋巴瘤患者的标准治疗方案。利妥昔单抗,一种抗CD20单克隆抗体,在治疗弥漫性大B细胞淋巴瘤方面有效。本研究旨在比较利妥昔单抗联合CHOP与单纯CHOP方案对新诊断的弥漫性大B细胞淋巴瘤患者的疗效,并分析其毒性。
72例新诊断的弥漫性大B细胞淋巴瘤患者前瞻性地分为2组并行对照:34例接受CHOP加利妥昔单抗(375mg/m²,每个疗程前2天)(联合组),38例接受单纯CHOP方案。每个疗程持续3周。所有病例在6个疗程后进行评估。
联合组总有效率为93.8%(30/32),其中23例完全缓解,7例部分缓解;CHOP组总有效率为75.0%(27/36),其中19例完全缓解,8例部分缓解。联合组治疗效果明显优于CHOP组(P<0.05)。联合组1年无进展生存率和总生存率明显高于CHOP组(81.2%对52.8%,93.8%对75.0%,P<0.05)。联合组主要不良事件为可耐受的输液相关反应,血液学毒性与CHOP组相似。
利妥昔单抗提高了CHOP方案对新诊断的弥漫性大B细胞淋巴瘤患者的治疗效果,且毒性无临床意义的增加。利妥昔单抗联合CHOP可作为弥漫性大B细胞淋巴瘤的一线治疗方案。