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利妥昔单抗联合 ABVD 方案治疗初诊经典型霍奇金淋巴瘤的Ⅱ期临床研究。

Phase 2 study of rituximab plus ABVD in patients with newly diagnosed classical Hodgkin lymphoma.

机构信息

Departments of Lymphoma and Myeloma, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA.

出版信息

Blood. 2012 May 3;119(18):4123-8. doi: 10.1182/blood-2012-01-405456. Epub 2012 Feb 27.

Abstract

In the present study, we evaluated the efficacy and safety of rituximab in combination with standard doxorubicin, bleomycin, vinblastine, and dacarbazine (RABVD) in patients with classical Hodgkin lymphoma (cHL). In this phase 2 study, patients with chemotherapy-naive, advanced-stage cHL were treated with rituximab 375 mg/m(2) weekly for 6 weeks and standard ABVD for 6 cycles. The primary outcome was event-free survival (EFS) at 5 years. Eighty-five patients were enrolled, of whom 78 were eligible. With a median follow-up duration of 68 months (range, 26-110), and based on an intent-to-treat analysis, the 5-year EFS and overall survival rates were 83% and 96%, respectively. The 5-year EFS for patients with stage III/IV cHL was 82%. Furthermore, the 5-year EFS for patients with an International Prognostic Score of 0-2 was 88% and for those with a score of > 2, it was 73%. The most frequent treatment-related grade 3 or 4 adverse events were neutropenia (23%), fatigue (9%), and nausea (8%). Our results demonstrate that the addition of rituximab to ABVD is safe and has a promising clinical activity in patients with advanced-stage cHL. These data are currently being confirmed in a multicenter randomized trial.

摘要

在本研究中,我们评估了利妥昔单抗联合标准多柔比星、博来霉素、长春碱和达卡巴嗪(RABVD)在经典型霍奇金淋巴瘤(cHL)患者中的疗效和安全性。在这项 2 期研究中,未经化疗的晚期 cHL 患者接受利妥昔单抗 375mg/m2 每周 1 次,共 6 周,联合标准 ABVD 治疗 6 个周期。主要终点是 5 年无事件生存(EFS)。共纳入 85 例患者,其中 78 例符合条件。中位随访时间为 68 个月(范围:26-110),基于意向治疗分析,5 年 EFS 和总生存率分别为 83%和 96%。III/IV 期 cHL 患者的 5 年 EFS 为 82%。此外,国际预后评分 0-2 分的患者 5 年 EFS 为 88%,评分>2 分的患者为 73%。最常见的 3 级或 4 级治疗相关不良事件为中性粒细胞减少(23%)、疲劳(9%)和恶心(8%)。我们的结果表明,在 ABVD 中加入利妥昔单抗是安全的,并且在晚期 cHL 患者中具有有前景的临床活性。这些数据目前正在一项多中心随机试验中得到证实。

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