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可溶性白细胞介素-2受体和C反应蛋白与苯达莫司汀挽救治疗惰性淋巴瘤和套细胞淋巴瘤疗效的相关性

Association of Soluble Interleukin-2 Receptor and C-Reactive Protein with the Efficacy of Bendamustine Salvage Treatment for Indolent Lymphomas and Mantle Cell Lymphoma.

作者信息

Kawaguchi Yukiko, Nakamaki Tsuyoshi, Abe Maasa, Baba Yuta, Murai So, Watanuki Megumi, Arai Nana, Fujiwara Shun, Kabasawa Nobuyuki, Tsukamoto Hiroyuki, Uto Yui, Ariizumi Hirotsugu, Yanagisawa Kouji, Hattori Norimichi, Harada Hiroshi, Saito Bungo

机构信息

Division of Hematology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan.

出版信息

Acta Haematol. 2018;139(1):12-18. doi: 10.1159/000484711. Epub 2018 Jan 5.

Abstract

Bendamustine has demonstrated favourable efficacy in relapsed or refractory indolent lymphoma and mantle cell lymphoma. We retrospectively evaluated the pre-treatment clinical and laboratory factors and their correlation with the clinical outcome of these lymphomas. We analysed 53 patients who had been treated with bendamustine alone (n = 6) or rituximab plus bendamustine (n = 47). The overall response rate was 81.1%, with a complete response (CR) rate of 39.6%. The CR rate was significantly low in patients who had elevated levels of soluble interleukin-2 receptor (p = 0.024) and C-reactive protein (CRP; p = 0.004). The 1-year overall survival (OS) rate was 79.3%. An elevated CRP was associated with a short OS (p = 0.056). The present findings suggest that the lymphoma microenvironment and immune response were involved in the effects of bendamustine. These findings are also important in order to understand the pathophysiology of refractory lymphoma and to find effective strategies using bendamustine.

摘要

苯达莫司汀已在复发或难治性惰性淋巴瘤和套细胞淋巴瘤中显示出良好疗效。我们回顾性评估了治疗前的临床和实验室因素及其与这些淋巴瘤临床结局的相关性。我们分析了53例接受单独苯达莫司汀治疗(n = 6)或利妥昔单抗联合苯达莫司汀治疗(n = 47)的患者。总缓解率为81.1%,完全缓解(CR)率为39.6%。可溶性白细胞介素-2受体水平升高(p = 0.024)和C反应蛋白(CRP;p = 0.004)的患者CR率显著较低。1年总生存率(OS)为79.3%。CRP升高与OS缩短相关(p = 0.056)。目前的研究结果表明,淋巴瘤微环境和免疫反应参与了苯达莫司汀的作用。这些发现对于理解难治性淋巴瘤的病理生理学以及寻找使用苯达莫司汀的有效策略也很重要。

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