Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou 510060, Guangdong, People's Republic of China.
Med Oncol. 2013 Mar;30(1):350. doi: 10.1007/s12032-012-0350-5. Epub 2013 Jan 18.
The combination of gemcitabine (G), vinorelbine (V), and pegylated liposomal doxorubicin (D) has proved to be effective in relapsed Hodgkin's lymphoma (HL). Its efficacy in non-Hodgkin's lymphoma (NHL) remains to be discussed. We retrospectively evaluated the efficacy and toxicity of the dose-adjusted gemcitabine, vinorelbine, liposomal doxorubicin (GVD) in 14-day schedule in 35 heavily pretreated patients with relapsed and refractory aggressive NHL or HL. Treatment consisted of G: 800 mg/m(2) intravenous (i.v.) on day 1, V: 15 mg/m(2) i.v. on day 1; D: 20 mg/m(2) i.v. on day 1, repeated for 14 days. Patients responded to GVD proceeded to subsequent autologous stem cell transplantation. The objective response rate (ORR) was 48.6 %, with 31.4 % complete remission. A higher ORR was observed in patients with HL than in patients with NHL (80.0 vs. 36.0 %, P = 0.023). With a median follow-up of 26 months, the estimated median progression-free survival and overall survival were 5 (range 1-73 months) and 36 months (range 2-73 months), respectively. The estimated 5-year survival rate was 44.6 % (95 % confidence interval 28.1-61.1 %). Toxicities were mild (grade 3/4 neutropenia 34.3 %, thrombocytopenia 5.7 %). Our results suggest that the dose-adjusted GVD in 14-day schedule is effective and well tolerated in patients with refractory and relapsed HL and aggressive NHL. The potential long-term survival in NHL is promising.
吉西他滨(G)、长春瑞滨(V)和聚乙二醇脂质体阿霉素(D)联合应用已被证明在复发的霍奇金淋巴瘤(HL)中有效。其在非霍奇金淋巴瘤(NHL)中的疗效仍有待讨论。我们回顾性评估了剂量调整的吉西他滨、长春瑞滨、脂质体阿霉素(GVD)在 14 天方案中的疗效和毒性,共 35 例复发和难治性侵袭性 NHL 或 HL 患者接受了治疗。治疗方案为:G 800 mg/m(2) 静脉滴注(i.v.),第 1 天;V 15 mg/m(2) i.v.,第 1 天;D 20 mg/m(2) i.v.,第 1 天,每 14 天重复一次。对 GVD 有反应的患者继续进行后续自体干细胞移植。客观缓解率(ORR)为 48.6%,完全缓解率为 31.4%。HL 患者的 ORR 高于 NHL 患者(80.0%比 36.0%,P = 0.023)。中位随访 26 个月时,估计的中位无进展生存期和总生存期分别为 5(1-73 个月)和 36 个月(2-73 个月)。估计的 5 年生存率为 44.6%(95%置信区间 28.1-61.1%)。毒性反应较轻(3/4 级中性粒细胞减少症 34.3%,血小板减少症 5.7%)。我们的结果表明,在难治性和复发性 HL 以及侵袭性 NHL 患者中,14 天方案的剂量调整 GVD 是有效且耐受良好的。NHL 的潜在长期生存率是有希望的。