Department of Human Pathology, University of Messina, Messina, Italy
Department of Human Pathology, University of Messina, Messina, Italy.
Anticancer Res. 2014 Sep;34(9):5121-5.
Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoma entity whose prognosis for high-risk patients is poor. Aggressive salvage treatments to improve patient outcome have been unsatisfactory. Therefore, we evaluated the efficacy of yttrium-90-ibritumomab tiuxetan (Zevalin®; (90)Y-IT) consolidation after early salvage chemotherapy with autologous stem cell transplantation. Thirty-seven patients with intermediate-high risk DLBCL not in complete remission (CR) after three cycles of rituximab, cyclophosphomide, doxorubicin, vincristine and prednisone (R-CHOP) were assessed retrospectively. After early salvage treatment, 70% achieved CR and 30% partial remission. Twenty patients underwent additional consolidation with (90)Y-IT. During the 3-year follow-up, 50% in the (90)Y-IT-treated group experienced relapse compared to 82.3% in the other cohort (p=0.002). Progression- and disease-free survival were significantly longer in the (90)Y-IT group. However, probably due to the relatively short follow-up period, no difference in overall survival was observed. (90)Y-IT consolidation after early salvage chemotherapy improves treatment responses and reduces the percentage of relapses without significant additional toxicities.
弥漫性大 B 细胞淋巴瘤（DLBCL）是最常见的淋巴瘤实体，其高危患者的预后较差。为改善患者的预后，已经尝试了多种强化挽救治疗，但结果并不令人满意。因此，我们评估了在早期挽救性化疗后用钇-90 替伊莫单抗替曲昔单抗（Zevalin®；（90）Y-IT）进行巩固治疗的疗效。我们回顾性评估了 37 例在接受利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松（R-CHOP）三联方案诱导治疗后未达完全缓解（CR）的中高危 DLBCL 患者。早期挽救治疗后，70%的患者达到 CR，30%的患者达到部分缓解。20 例患者接受了（90）Y-IT 进一步巩固治疗。在 3 年的随访中，（90）Y-IT 治疗组 50%的患者复发，而另一组的复发率为 82.3%（p=0.002）。（90）Y-IT 组的疾病进展和无病生存率显著更长。然而，可能由于随访时间相对较短，两组的总生存率没有差异。早期挽救性化疗后用（90）Y-IT 进行巩固治疗可提高治疗反应率，降低复发率，而不会显著增加毒性。
