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[利妥昔单抗治疗弥漫性大B细胞淋巴瘤的临床病理特征与疗效的关系]

[Relationship between clinopathological features and outcome of rituximab treatment for diffuse large B-cell lymphoma].

作者信息

Zhang Hong-Yu, Guan Zhong-Zhen, Wang Bo, Huang Hui-Qiang, Xia Zhong-Jun, Lin Tong-Yu

机构信息

Department of Medical Oncology, Cancer Center, Sun Yat-sen University, Guangzhou 510060, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2008 May;30(5):381-4.

Abstract

OBJECTIVE

To investigate the relationship of clinopathological features and outcome of rituximab treatment for diffuse large B-cell lymphoma (DLBCL).

METHODS

Sixty-nine patients with DLBCL received intravenous infusion of rituximab in combination with different chemotherapy regimens have been retrospectively analyzed. The influencing factors such as age, stage, serum level of lactate dehydrogenase (LDH) and bulky disease were analyzed retrospectively in terms of the response. The anti-/ pro-apoptosis proteins were detected by immunohistochemistry (SP methods). The correlation of protein expression with efficacy of rituximab treatment was also analyzed.

RESULTS

In the patients with previously untreated aggressive B-NHL, the combination of rituximab with chemotherapy achieved an overall response rate (ORR) of 90.7% and CR of 69.8%, while in the patients with relapsed disease, that was 80.8% (ORR) and 30.8% (CR). The disease stage (P = 0.046), serum lactate dehydrogenase (LDH) (P = 0.024), physical status (P = 0.009) and bulky disease (P = 0.013) were found to be unfavorable factors for the immunochemotherapy. The treatment efficacy in the patients with Bcl-2 overexpression was better than that in cases with negative one. No correlation of the bax and survivin expression with immunochemotherapy efficacy was observed.

CONCLUSION

The immunochemotherapy regimen (rituximab plus chemotherapy) can improve the response rate and CR rate without significant increase in toxicity in patients with diffuse large B-cell lymphoma. The advanced stage, high serum LDH level, relapsed disease, bulky disease and negative Bcl-2 expression are unfavorable factors affecting the therapeutic efficacy.

摘要

目的

探讨弥漫性大B细胞淋巴瘤(DLBCL)患者的临床病理特征与利妥昔单抗治疗结局的关系。

方法

回顾性分析69例接受利妥昔单抗联合不同化疗方案静脉输注治疗的DLBCL患者。回顾性分析年龄、分期、血清乳酸脱氢酶(LDH)水平和大包块病变等影响因素与反应情况的关系。采用免疫组织化学(SP法)检测抗凋亡/促凋亡蛋白。分析蛋白表达与利妥昔单抗治疗疗效的相关性。

结果

在先前未治疗的侵袭性B-NHL患者中,利妥昔单抗联合化疗的总缓解率(ORR)为90.7%,完全缓解(CR)率为69.8%;而在复发患者中,ORR为80.8%,CR为30.8%。疾病分期(P = 0.046)、血清乳酸脱氢酶(LDH)(P = 0.024)、身体状况(P = 0.009)和大包块病变(P = 0.013)被发现是免疫化疗的不利因素。Bcl-2过表达患者的治疗疗效优于阴性患者。未观察到bax和survivin表达与免疫化疗疗效的相关性。

结论

免疫化疗方案(利妥昔单抗加化疗)可提高弥漫性大B细胞淋巴瘤患者的缓解率和CR率,且毒性无显著增加。晚期、血清LDH水平高、复发疾病、大包块病变和Bcl-2表达阴性是影响治疗疗效的不利因素。

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