Suppr超能文献

我是如何管理复发/难治性弥漫性大 B 细胞淋巴瘤患者的。

How I manage patients with relapsed/refractory diffuse large B cell lymphoma.

机构信息

Hôpital Saint Louis, Paris, France.

Cliniques universitaires UCL Saint-Luc, Brussels, Belgium.

出版信息

Br J Haematol. 2018 Sep;182(5):633-643. doi: 10.1111/bjh.15412. Epub 2018 May 29.

Abstract

Despite progress in the upfront treatment of diffuse large B cell lymphoma (DLBCL), patients still experience relapses. Salvage chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard second-line treatment for relapsed and refractory (R/R) DLBCL. However, half of the patients will not be eligible for transplantation due to ineffective salvage treatment, and the other half will relapse after ASCT. In randomized studies, no salvage chemotherapy regimen is superior to another. The outcomes are affected by the secondary International Prognostic Index at relapse and various biological factors. The strategy is less clear in patients who require third-line treatment. A multicohort retrospective non-Hodgkin lymphoma research (SCHOLAR-1) study conducted in 636 patients with refractory DLBCL showed an objective response rate of 26% (complete response 7%) to the next line of therapy with a median overall survival of 6·3 months. In the case of a response followed by transplantation, long-term survival can be achieved in DLBCL patients. There is clearly a need for new drugs that improve salvage efficacy. Encouraging results have been reported with chimeric antigen receptor -T cell engineering, warranting further studies in a well-defined control group of refractory patients. The Collaborative Trial in Relapsed Aggressive Lymphoma (CORAL) was used as a handy framework to build the discussion.

摘要

尽管弥漫性大 B 细胞淋巴瘤 (DLBCL) 的初始治疗取得了进展,但患者仍会复发。挽救性化疗后自体干细胞移植 (ASCT) 是复发和难治性 (R/R) DLBCL 的标准二线治疗方法。然而,由于挽救性治疗无效,一半的患者将没有资格进行移植,另一半患者在 ASCT 后会复发。在随机研究中,没有一种挽救性化疗方案优于另一种方案。结果受到复发时次要国际预后指数和各种生物学因素的影响。对于需要三线治疗的患者,策略不太明确。在一项纳入 636 例难治性 DLBCL 患者的多队列回顾性非霍奇金淋巴瘤研究 (SCHOLAR-1) 中,下一线治疗的客观缓解率为 26%(完全缓解率为 7%),中位总生存期为 6.3 个月。在有反应并随后进行移植的情况下,DLBCL 患者可以实现长期生存。显然需要新的药物来提高挽救疗效。嵌合抗原受体-T 细胞工程的令人鼓舞的结果已经报道,需要在明确界定的难治性患者对照组中进一步研究。复发性侵袭性淋巴瘤合作试验 (CORAL) 被用作构建讨论的便捷框架。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53e3/6175435/cf237ad0d3dd/BJH-182-633-g001.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验