CHOP联合不同抗逆转录病毒治疗方案治疗弥漫性大B细胞淋巴瘤的安全性和有效性：SCULPT研究

Safety and efficacy of CHOP for treatment of diffuse large B-cell lymphoma with different combination antiretroviral therapy regimens: SCULPT study.

作者信息

Wong Alison Y J, Marcotte Suzanne, Laroche Mathieu, Sheehan Nancy L, Kukreti Vishal, Routy Jean-Pierre, Lemieux Bernard, Seki Jack T, Rouleau Danielle, Tseng Alice

机构信息

Chronic Viral Illness Service, McGill University Health Centre, Montréal, QC, Canada.

出版信息

Antivir Ther. 2013;18(5):699-707. doi: 10.3851/IMP2572. Epub 2013 May 2.

DOI:10.3851/IMP2572

PMID:23640963

Abstract

BACKGROUND

Use of combination antiretroviral therapy (cART) and cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) with or without rituximab for treatment of diffuse large B-cell lymphoma (DLBCL) in HIV substantially increases response rates but may also increase toxicity, possibly due to antiretroviral-antineoplastic drug interactions. The objective of this study was to evaluate the frequency of complete remission (CR) of DLBCL in patients treated with CHOP while receiving a protease inhibitor (PI) versus a non-PI-based cART.

METHODS

A retrospective multicentre pilot study was conducted in HIV-infected patients on cART treated for DLBCL with CHOP between 2002-2010 in three academic hospitals.

RESULTS

A total of 34 patients were included with 65% and 35% of patients receiving a PI and non-PI-based cART, respectively. Baseline characteristics between groups were similar; overall 85% were male, median age was 43 years, 50% had an International Prognostic Index (IPI) of 2-3 and median CD4(+) T-cell count was 225 cells/mm(3). CR was achieved in 77% and 58% of patients in the PI and non-PI groups, respectively (P=0.21), with 65% and 63% of patients achieving 2-year overall survival (P=1.00). A multivariate analysis showed that lower IPI score alone was significantly associated with higher CR rates (P=0.05). Toxicity was similar between both groups.

CONCLUSIONS

Similar efficacy and toxicity of CHOP was observed in patients receiving a PI and non-PI-based cART.

摘要

背景

使用联合抗逆转录病毒疗法（cART）以及环磷酰胺、多柔比星、长春新碱和泼尼松（CHOP），无论是否联合利妥昔单抗来治疗HIV相关的弥漫性大B细胞淋巴瘤（DLBCL），虽可显著提高缓解率，但也可能增加毒性，这可能是由于抗逆转录病毒药物与抗肿瘤药物之间的相互作用所致。本研究的目的是评估在接受CHOP治疗的同时接受蛋白酶抑制剂（PI）与非基于PI的cART的DLBCL患者中完全缓解（CR）的频率。

方法

2002年至2010年期间，在三家学术医院对接受cART治疗的HIV感染患者进行了一项回顾性多中心试点研究，这些患者采用CHOP治疗DLBCL。

结果

共纳入34例患者，分别有65%和35%的患者接受基于PI和非基于PI的cART。两组之间的基线特征相似；总体上85%为男性，中位年龄为43岁，50%的国际预后指数（IPI）为2 - 3，中位CD4(+) T细胞计数为225个细胞/mm³。PI组和非PI组分别有77%和58%的患者实现CR（P = 0.21），65%和63%的患者实现2年总生存（P = 1.00）。多因素分析显示，仅较低的IPI评分与较高的CR率显著相关（P = 0.05）。两组之间的毒性相似。