Department of Haematological Medicine, King's College Hospital NHS Foundation Trust and King's College London, London, UK.
Leuk Res. 2012 Jul;36(7):857-61. doi: 10.1016/j.leukres.2011.12.004. Epub 2011 Dec 29.
Adult T-cell leukaemia lymphoma (ATLL) is an aggressive T-cell malignancy caused by the human T-lymphotropic virus type-1 (HTLV-1) and is associated with a very poor prognosis. Combination chemotherapy has had little impact on the long term survival of these patients. ATLL cells are characterised by the expression of CD25 (IL-2Rα), which is not expressed in normal resting T-cells. Daclizumab (Zenapax(®)) is a humanised murine anti-CD25 monoclonal antibody, which contains 10% murine CDR sequences. In this prospective trial 15 patients with aggressive ATLL were treated with CHOP-Zenapax (CHOP-Z) to determine the tolerability and feasibility of this novel regimen as well as evaluate its efficacy. Eleven patients had acute ATLL and four had the lymphoma subtype. The main presenting features were elevated LDH (100%), lymphocytosis (73%), lymphadenopathy (67%), skin lesions (40%), hypercalcaemia (53%), and hepato-splenomegaly (27%). Ten (67%) patients received the six scheduled cycles. Complete response (CR) lasting for two months or more was seen in 5 (33%), partial response in 3 (20%), minor response in 1 (7%), and no response in 6 (40%) patients. The median overall survival was 10 months (95% CI: 0.05-20.88) but this was significantly longer among responders (18 months) compared to non responders (3 months) (P = 0.019). For patients who achieved CR the disease free survival (DFS) was 15 months while the event-free survival (EFS) was 5 months. In conclusion CHOP-Z is safe and in those who achieve a complete response it was associated with prolonged overall survival.
成人 T 细胞白血病淋巴瘤（ATLL）是一种由人类 T 淋巴细胞病毒 1 型（HTLV-1）引起的侵袭性 T 细胞恶性肿瘤，预后极差。联合化疗对这些患者的长期生存几乎没有影响。ATLL 细胞的特征是表达 CD25（IL-2Rα），而正常静息 T 细胞不表达。达珠单抗（Zenapax(®)）是一种人源化鼠抗 CD25 单克隆抗体，含有 10%鼠 CDR 序列。在这项前瞻性试验中，15 例侵袭性 ATLL 患者接受 CHOP-Zenapax（CHOP-Z）治疗，以确定这种新方案的耐受性和可行性，并评估其疗效。11 例患者为急性 ATLL，4 例为淋巴瘤亚型。主要表现为乳酸脱氢酶升高（100%）、淋巴细胞增多（73%）、淋巴结病（67%）、皮肤病变（40%）、高钙血症（53%）和肝脾肿大（27%）。10 例（67%）患者接受了 6 个预定周期的治疗。5 例（33%）患者获得持续 2 个月或更长时间的完全缓解（CR），3 例（20%）患者获得部分缓解，1 例（7%）患者获得轻微缓解，6 例（40%）患者无缓解。中位总生存期为 10 个月（95%CI：0.05-20.88），但缓解者（18 个月）明显长于无缓解者（3 个月）（P=0.019）。对于获得 CR 的患者，无病生存（DFS）为 15 个月，而无事件生存（EFS）为 5 个月。总之，CHOP-Z 是安全的，对于获得完全缓解的患者，它与延长总生存期相关。
