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利妥昔单抗联合CHOP方案治疗局限性原发性胃弥漫性大B细胞淋巴瘤的长期随访

Long-term follow-up of localized, primary gastric diffuse large B-cell lymphoma treated with rituximab and CHOP.

作者信息

Kobayashi Yujin, Hatta Yoshihiro, Hojo Atsuko, Kura Yoshimasa, Uchino Yoshihito, Takahashi Hiromichi, Kiso Satomi, Hirabayashi Yukio, Yagi Mai, Kodaira Hitomi, Kurita Daisuke, Tanaka Toshitake, Miura Katsuhiro, Iriyama Noriyoshi, Kobayashi Sumiko, Sawada Umihiko, Sugitani Masahiko, Takeuchi Jin

机构信息

Departments of Hematology and Rheumatology and.

出版信息

Exp Ther Med. 2012 Feb;3(2):304-308. doi: 10.3892/etm.2011.387. Epub 2011 Nov 22.

Abstract

The addition of rituximab to cyclophosphamide, doxorubicin, vincristine and prednisone [CHOP (i.e., R-CHOP)] is considered to be the standard regimen for treating localized, primary gastric diffuse large B-cell lymphoma (PG-DLBCL). However, few studies have reported the long-term efficacy of R-CHOP therapy in the management of localized PG-DLBCL. In the present study, we performed a retrospective analysis of 11 patients with localized PG-DLBCL, who were treated with R-CHOP at Nihon University Itabashi Hospital and Kasukabe Municipal Hospital (Japan) from 2001 to 2008. Limited stage cancer was defined as stage I/II according to the Lugano staging system for gastrointestinal (GI) lymphomas. The relative dose intensity (RDI) of CHOP therapy was calculated for each patient. The median age of the patients was 68 years (range, 48-82). Gastralgia and anemia were common symptoms at initial presentation. All patients except 1 received 6 cycles of R-CHOP treatment without consolidative radiation therapy or prior surgery. RDI was maintained at over 80% in 9 out of 11 patients. All patients achieved complete remission and the estimated overall survival with a median follow-up of 54 months (range, 39-103) was 100%, without relapse or significant GI adverse effects, such as perforation or bleeding during R-CHOP treatment. No long-term adverse effects of rituximab were recorded during the observation period. Helicobacter pylori infection was diagnosed in 72.7% (8 cases) of the patients, but was eradicated in a limited number of patients. Our data suggest the feasibility and effectiveness of the addition of rituximab to conventional CHOP therapy in the management of localized PG-DLBCL.

摘要

将利妥昔单抗添加到环磷酰胺、阿霉素、长春新碱和泼尼松(即CHOP方案,也就是R-CHOP方案)中被认为是治疗局限性原发性胃弥漫性大B细胞淋巴瘤(PG-DLBCL)的标准方案。然而,很少有研究报道R-CHOP疗法在局限性PG-DLBCL治疗中的长期疗效。在本研究中,我们对11例局限性PG-DLBCL患者进行了回顾性分析,这些患者于2001年至2008年在日本日本大学板桥医院和春日部市立医院接受了R-CHOP治疗。根据胃肠道(GI)淋巴瘤的卢加诺分期系统,局限期癌症被定义为I/II期。计算了每位患者CHOP疗法的相对剂量强度(RDI)。患者的中位年龄为68岁(范围48 - 82岁)。胃痛和贫血是初始表现时的常见症状。除1例患者外,所有患者均接受了6个周期的R-CHOP治疗,未进行巩固性放疗或术前手术。11例患者中有9例RDI维持在80%以上。所有患者均实现完全缓解,中位随访54个月(范围39 - 103个月)时的估计总生存率为100%,在R-CHOP治疗期间无复发或明显的胃肠道不良反应,如穿孔或出血。在观察期内未记录到利妥昔单抗的长期不良反应。72.7%(8例)的患者诊断为幽门螺杆菌感染,但仅有少数患者根除了该感染。我们的数据表明,在局限性PG-DLBCL的治疗中,将利妥昔单抗添加到传统CHOP疗法中是可行且有效的。

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