两周一次剂量调整（DA）-EPOCH 样化疗联合高剂量地塞米松和利妥昔单抗（DA-EDOCH14-R）治疗不良预后未经治疗的弥漫性大 B 细胞淋巴瘤。

Two-weekly dose-adjusted (DA)-EPOCH-like chemotherapy with high-dose dexamethasone plus rituximab (DA-EDOCH14-R) in poor-prognostic untreated diffuse large B-cell lymphoma.

机构信息

Haematology Service, Department of Medicine, Príncipe de Asturias University Hospital, University of Alcalá, Alcalá de Henares, Madrid, Spain.

出版信息

Br J Haematol. 2013 Feb;160(4):510-4. doi: 10.1111/bjh.12144. Epub 2012 Dec 11.

DOI:10.1111/bjh.12144

PMID:23228045

Abstract

The activity and safety of two-weekly dose-adjusted (DA)-EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin)-like chemotherapy with high-dose dexamethasone plus rituximab (DA-EDOCH14-R) was explored in 20 patients with previously untreated poor prognosis diffuse large B-cell lymphoma (DLBCL). The main outcomes were compared with those of 27 poor-prognosis patients enrolled into a previous trial of 3-weekly DA-EPOCH-R. Toxicity was manageable and there were no therapy-related deaths. Three-year progression-free survival (PFS) was superior in the DA-EDOCH14-R group (95% vs. 74%, P = 0·08). Importantly, this improvement in PFS with the two-weekly DA-EDOCH14-R was particularly notable in patients with an age-adjusted International Prognostic Index of 3 (100% vs. 30%, P < 0·001).

摘要

20 例未经治疗的预后不良弥漫性大 B 细胞淋巴瘤（DLBCL）患者接受了两周一次的剂量调整（DA）-EPOCH（依托泊苷、泼尼松、长春新碱、环磷酰胺、多柔比星）样化疗联合高剂量地塞米松和利妥昔单抗（DA-EDOCH14-R），并对其活性和安全性进行了探索。主要结局与之前 3 周一次的 DA-EPOCH-R 试验中纳入的 27 例预后不良患者的结果进行了比较。毒性可控制，无治疗相关死亡。DA-EDOCH14-R 组的 3 年无进展生存率（PFS）更高（95% vs. 74%，P=0·08）。重要的是，在年龄调整后的国际预后指数为 3 的患者中，这种两周一次的 DA-EDOCH14-R 方案改善 PFS 的效果尤其显著（100% vs. 30%，P < 0·001）。