Magyari Ferenc, Barna Sándor, Husi Kata, Simon Zsófia, Miltényi Zsófia, Váróczy László, Udvardy Miklós, Illés Árpád
a Department of Hematology , Institute for Internal Medicine, Faculty of Medicine, University of Debrecen , Debrecen , Hungary.
b Scanomed Ltd , Debrecen , Hungary.
Hematology. 2016 Aug;21(7):404-10. doi: 10.1080/10245332.2015.1115192. Epub 2016 Mar 1.
Hodgkin's lymphoma (HL) is a well-curable disease. The treatment usually includes combined multiagent conventional chemotherapy and radiotherapy. One-fifth of the patients need repeated treatments because of relapse or primary progressive disease. Those HL patients, who cannot be cured at least with salvage therapy (including autologous haemopoietic stem cell transplantation (auto-HSCT)), have really unfavourable prognosis.
For this heavily pretreated subset of HL patients, novel but less toxic treatment strategies should be considered. Brentuximab-vedotin (BV) is a novel targeted treatment option, which was administered after the failure of two different regimens in patients, who were ineligible for auto-HSCT or after the failure of auto-HSCT. Moreover, there are favourable data with chemotherapeutical regimens supplemented with rituximab not only in relapsed but also in newly diagnosed classical HL patients. Bendamustine, an almost forgotten 50-year-old drug, lives its renaissance in the twenty-first century, which can be administered in refractory HL as well. Combination of the 'new' and 'old' drugs might be also helpful.
Our data suggest that rituximab plus bendamustine (supplemented with or without BV) could be a suitable alternative bridging salvage therapy for heavily pretreated HL patients.
霍奇金淋巴瘤(HL)是一种可治愈的疾病。其治疗通常包括联合多种传统化疗和放疗。五分之一的患者因复发或原发性进行性疾病需要重复治疗。那些至少经挽救性治疗(包括自体造血干细胞移植(auto-HSCT))仍无法治愈的HL患者,预后确实不佳。
对于这一经过大量预处理的HL患者亚组,应考虑采用新型但毒性较小的治疗策略。本妥昔单抗(BV)是一种新型靶向治疗选择,在两种不同方案治疗失败后,用于不符合auto-HSCT条件的患者或auto-HSCT失败后的患者。此外,不仅在复发的经典HL患者中,而且在新诊断的患者中,补充利妥昔单抗的化疗方案也有良好的数据。苯达莫司汀,一种几乎被遗忘了50年的药物,在21世纪迎来了复兴,也可用于难治性HL。“新”药与“旧”药联合使用可能也有帮助。
我们的数据表明,利妥昔单抗加苯达莫司汀(补充或不补充BV)可能是经过大量预处理的HL患者挽救性治疗的合适替代方案。