Aguiar Bujanda David, Aguiar Morales José, Bohn Sarmiento Uriel, Saura Grau Salvador, Rodríguez Franco Carlos
Servicio de Oncología Médica, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain.
Clin Transl Oncol. 2009 Sep;11(9):604-8. doi: 10.1007/s12094-009-0411-1.
The results of CHOP-21 (cyclophosphamide, doxorubicin, vincristine and prednisone given every 21 days) for the treatment of aggressive B-cell lymphoma have recently been improved by the addition of rituximab and by increasing the dose density. R-CHOP-14 combines these two approaches.
We present our experience with R-CHOP-14 in a retrospective single-centre review of 50 patients consecutively treated for aggressive B-cell lymphoma.
The median age was 59 years and 48% of patients were >60 years. Stage III-IV was present in 62% of the patients and international prognostic index was high-to-intermediate risk or high risk in 32% of the patients. Toxicity was mainly haematological, with grade 3-4 neutropenia observed in 32% and febrile neutropenia in 18%. Other relevant toxicities were peripheral neuropathy in 45% (grade 3 in 4%) and cardiac dysfunction grade 3 in 7.5%. After therapy, 82% of the patients achieved complete response or unproved complete response. With a median follow-up of 30 months, 3-year event-free survival and overall survival were 67% and 82% respectively.
In our experience the combination of RCHOP- 14 is highly effective in patients with aggressive B-cell lymphoma. However special attention must be paid to the control of early and late toxicities.
环磷酰胺、阿霉素、长春新碱和强的松每21天给药一次（CHOP-21）治疗侵袭性B细胞淋巴瘤的疗效，最近因添加利妥昔单抗和增加剂量密度而得到改善。R-CHOP-14结合了这两种方法。
我们在一项回顾性单中心研究中，介绍了R-CHOP-14治疗50例连续接受侵袭性B细胞淋巴瘤治疗患者的经验。
中位年龄为59岁，48%的患者年龄>60岁。62%的患者为III-IV期，32%的患者国际预后指数为高-中危或高危。毒性主要为血液学毒性，32%的患者出现3-4级中性粒细胞减少，18%的患者出现发热性中性粒细胞减少。其他相关毒性包括45%的患者出现周围神经病变（4%为3级）和7.5%的患者出现3级心脏功能障碍。治疗后，82%的患者达到完全缓解或未证实的完全缓解。中位随访30个月，3年无事件生存率和总生存率分别为67%和82%。
根据我们的经验，R-CHOP-14联合方案对侵袭性B细胞淋巴瘤患者非常有效。然而，必须特别注意控制早期和晚期毒性。
