Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
J Clin Oncol. 2010 Jan 20;28(3):412-7. doi: 10.1200/JCO.2009.23.4245. Epub 2009 Dec 14.
Statins have antilymphoma properties but have also been shown to inhibit the binding of rituximab to the CD20 antigen, resulting in reduced antitumor activity of rituximab in vitro. The clinical impact of statin use on the outcome of lymphoma patients treated with a rituximab-containing regimen is unknown.
Consecutive patients with newly diagnosed, diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) were enrolled onto a registry and observed prospectively. The impact of statin use on patients' outcomes was analyzed.
Two hundred twenty-eight patients with DLBCL and 293 patients with FL were enrolled from September 2002 through June 2007; 21% of patients with DLBCL and 19% of patients with FL were on statins at diagnosis, and 20% and 17% remained on statins during lymphoma treatment, respectively. All patients with DLBCL and 39% of patients with FL received initial therapy containing rituximab. The median follow-up time was 47 months (range, 13 to 80 months). Statin use had no impact on the overall response rate (P = .67), overall survival (P = .76), or event-free survival (EFS) in patients with DLBCL (hazard ratio [HR] = 0.85; 95% CI, 0.43 to 1.68). Statin use at diagnosis was associated with improved EFS in patients with FL (HR = 0.45; 95% CI, 0.26 to 0.77), including subgroups treated with rituximab or a rituximab-containing regimen (HR = 0.38; 95% CI, 0.14 to 1.07) and patients who were observed only (HR = 0.38; 95% CI, 0.17 to 0.84).
The concurrent use of statins during the treatment of patients with DLBCL and FL in the rituximab era did not adversely affect outcome. The apparent benefit of statin therapy on FL outcome requires further studies.
他汀类药物具有抗淋巴瘤特性，但也已被证明可抑制利妥昔单抗与 CD20 抗原的结合，从而导致利妥昔单抗在体外的抗肿瘤活性降低。他汀类药物的使用对接受利妥昔单抗联合方案治疗的淋巴瘤患者结局的临床影响尚不清楚。
连续纳入 2002 年 9 月至 2007 年 6 月期间新诊断为弥漫性大 B 细胞淋巴瘤（DLBCL）和滤泡性淋巴瘤（FL）的患者，并前瞻性观察。分析他汀类药物的使用对患者结局的影响。
共纳入 228 例 DLBCL 患者和 293 例 FL 患者；21%的 DLBCL 患者和 19%的 FL 患者在诊断时正在服用他汀类药物，分别有 20%和 17%的患者在淋巴瘤治疗期间仍在服用他汀类药物。所有 DLBCL 患者和 39%的 FL 患者接受了包含利妥昔单抗的初始治疗。中位随访时间为 47 个月（范围 13 至 80 个月）。他汀类药物的使用对 DLBCL 患者的总缓解率（P =.67）、总生存率（P =.76）或无事件生存率（EFS）均无影响（风险比 [HR] = 0.85；95%CI，0.43 至 1.68）。诊断时使用他汀类药物与 FL 患者的 EFS 改善相关（HR = 0.45；95%CI，0.26 至 0.77），包括接受利妥昔单抗或利妥昔单抗联合方案治疗的亚组（HR = 0.38；95%CI，0.14 至 1.07）和仅观察的患者（HR = 0.38；95%CI，0.17 至 0.84）。
在利妥昔单抗时代，DLBCL 和 FL 患者治疗期间同时使用他汀类药物不会对结局产生不利影响。他汀类药物治疗对 FL 结局的明显获益需要进一步研究。
