THP-COP 方案治疗外周 T 细胞淋巴瘤和成人 T 细胞白血病/淋巴瘤：一项多中心 II 期研究。
THP-COP regimen for the treatment of peripheral T-cell lymphoma and adult T-cell leukemia/lymphoma: a multicenter phase II study.
机构信息
Division of Medical Oncology, Hematology and Infectious Disease, Department of Medicine, Fukuoka University, Jonan-ku, Fukuoka, Japan.
出版信息
Eur J Haematol. 2010 May;84(5):391-7. doi: 10.1111/j.1600-0609.2010.01411.x. Epub 2010 Jan 5.
OBJECTIVE
The efficacy of pirarubicin (THP)-COP was previously compared with cyclophophamide + doxorubicin + vincristine + prednisolone (CHOP) in elderly patients with lymphoma. The subset analysis showed that T-cell lymphoma had a significantly better response with THP-COP, whereas no such difference was observed in B-cell lymphoma. The aim of this study is to confirm the efficacy of THP-COP in the treatment of T-cell lymphoma.
METHODS
We underwent a multicenter phase II study of THP-COP as a first-line treatment for T-cell lymphoma. The overall response rate, survival period, and toxicity were analyzed.
RESULTS
Fifty-three patients were enrolled in this study. Seventeen patients had peripheral T-cell lymphoma (PTCL), including nine of PTCL not otherwise specified (PTCL-NOS) and eight of angioimmunoblastic T-cell lymphoma (AITL). Thirty-six patients had adult T-cell leukemia/lymphoma (ATLL), including 20 of acute type and 16 of lymphoma type. A treatment response was obtained in 35 (66%) patients, including 17 (32%) complete responses. Median overall survival (OS) and progression-free survival (PFS) times were 14.3 months and 5.2 months, respectively. Patients with ATLL showed a tendency to obtain low response rate (61% vs. 77%, P = 0.27) and had a significantly inferior OS (13.3 vs. 28.6 months, P = 0.04) and PFS (4.6 vs. 8.1 months, P = 0.01) in comparison with PTCL. Grade 3 to 4 neutropenia, anemia, and thrombocytopenia occurred in 72%, 34%, and 58% of the patients, respectively. Febrile neutropenia was observed in 51% and grade 3 non-hematological toxicities in 2-9% of the patients.
CONCLUSION
The efficacy of THP-COP is equivalent to that of CHOP for the first-line therapy in T-cell lymphoma.
目的
先前比较了吡柔比星（THP）-COP 与环磷酰胺+多柔比星+长春新碱+泼尼松（CHOP）在老年淋巴瘤患者中的疗效。亚组分析显示，T 细胞淋巴瘤患者使用 THP-COP 治疗的反应明显更好，而 B 细胞淋巴瘤则没有观察到这种差异。本研究的目的是确认 THP-COP 在 T 细胞淋巴瘤治疗中的疗效。
方法
我们进行了一项多中心 II 期研究，使用 THP-COP 作为 T 细胞淋巴瘤的一线治疗。分析了总缓解率、生存期和毒性。
结果
本研究共纳入 53 例患者。17 例患者患有外周 T 细胞淋巴瘤（PTCL），包括 9 例未特指的 PTCL（PTCL-NOS）和 8 例血管免疫母细胞性 T 细胞淋巴瘤（AITL）。36 例患者患有成人 T 细胞白血病/淋巴瘤（ATLL），包括 20 例急性型和 16 例淋巴瘤型。35 例（66%）患者获得治疗反应，包括 17 例（32%）完全缓解。中位总生存期（OS）和无进展生存期（PFS）分别为 14.3 个月和 5.2 个月。ATLL 患者的反应率较低（61%比 77%，P = 0.27），OS（13.3 比 28.6 个月，P = 0.04）和 PFS（4.6 比 8.1 个月，P = 0.01）明显较差。72%的患者出现 3-4 级中性粒细胞减少症、贫血和血小板减少症，分别为 34%和 58%的患者出现发热性中性粒细胞减少症和 2-9%的患者出现 3 级非血液学毒性。
结论
THP-COP 的疗效与 CHOP 相当，可作为 T 细胞淋巴瘤的一线治疗药物。
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