Neumann Frank, Harmsen Stefani, Martin Simona, Kronenwett Ralf, Kondakci Mustafa, Aivado Manuel, Germing Ulrich, Haas Rainer, Kobbe Guido
Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University, Duesseldorf Moorenstr. 5, 40225, Duesseldorf, Germany.
Ann Hematol. 2006 Aug;85(8):530-4. doi: 10.1007/s00277-006-0113-5. Epub 2006 Apr 26.
Treatment of B-cell non-Hodgkin's lymphomas (NHL) with either Rituximab alone or in combination with cytotoxic chemotherapy has been effective without major side effects. Thus, Rituximab maintenance therapy after autologous peripheral blood stem cell transplantation (PBSCT) might represent an improvement in NHL therapy. We therefore retrospectively analyzed the efficacy and side effects of monthly long-term Rituximab maintenance therapy after PBSCT in 27 patients with NHL. In median 10 infusions of Rituximab were given after PBSCT in time intervals of 1 month. Molecular monitoring of t(14;18) was performed using nested as well as quantitative real time polymerase chain reaction (RT-PCR) based on the LightCycler technology. Side effects according to common toxicity criteria (CTC) > II did mainly affect the hematopoietic system. In total, 10 patients (37%) suffered form grade III-IV hematotoxicity. Except for two patients with cutaneous Varicella-Zoster infection no serious infectious complications (CTC grade III/IV) occurred. No patient died because of treatment-related causes. This adverse event data compared favorably to the published data. Three patients had t(14;18) nested RT-PCR positive results before Rituximab therapy and converted to negativity after Rituximab therapy. We conclude that a prolonged Rituximab maintenance therapy after PBSCT with monthly administration is reliable and safe.
单独使用利妥昔单抗或与细胞毒性化疗联合治疗B细胞非霍奇金淋巴瘤（NHL）已取得疗效，且无严重副作用。因此，自体外周血干细胞移植（PBSCT）后进行利妥昔单抗维持治疗可能会改善NHL的治疗效果。我们因此回顾性分析了27例NHL患者在PBSCT后每月进行长期利妥昔单抗维持治疗的疗效和副作用。PBSCT后，中位进行了10次利妥昔单抗输注，时间间隔为1个月。基于LightCycler技术，采用巢式及定量实时聚合酶链反应（RT-PCR）对t(14;18)进行分子监测。根据常见毒性标准（CTC）> II级的副作用主要影响造血系统。共有10例患者（37%）出现III-IV级血液毒性。除2例皮肤水痘-带状疱疹感染患者外，未发生严重感染并发症（CTC III/IV级）。无患者因治疗相关原因死亡。该不良事件数据与已发表数据相比更优。3例患者在利妥昔单抗治疗前t(14;18)巢式RT-PCR检测结果为阳性，治疗后转为阴性。我们得出结论，PBSCT后每月进行延长的利妥昔单抗维持治疗是可靠且安全的。
