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利妥昔单抗与标准化疗方案联合应用于既往未治疗的慢性淋巴细胞白血病患者的真实疗效:一项非干预性研究(CILI研究)结果

Effectiveness of the Combination of Rituximab and Standard Chemotherapeutic Regimens in Previously Untreated Patients with Chronic Lymphocytic Leukaemia in Real-Life: Results from a Noninterventional Study (CILI Study).

作者信息

Szász Róbert, Altai Elvira, Pál Katalin, Dombi Péter, Iványi János, Jakucs János, Jóni Natália, Illés Árpád, Tárkányi Ilona, Szerafin László, Nagy Zsolt, Farkas Péter, Nagy Ágnes, Piukovics Klára, Ujj György, Schneider Tamás

机构信息

Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, Debrecen, 4032, Hungary.

Veszprém County Csolnoky Ferenc Hospital, Kórház u. 1, Veszprém, 8200, Hungary.

出版信息

Pathol Oncol Res. 2019 Apr;25(2):535-540. doi: 10.1007/s12253-018-0474-9. Epub 2018 Oct 25.

Abstract

Chronic lymphocytic leukemia (CLL) is one of the most common haematological malignancies exhibiting remarkable heterogeneity in clinical course. Rituximab added to standard chemotherapy has been proven to increase response rate and eventually survival among previously untreated CLL patients. CILI was an open-label, non-randomized, single arm, multicentric, observational study aimed to collect real-life effectiveness data for rituximab used according to the current label in combination with standard chemotherapy in previously untreated CLL patients. Overall response rates (ORR) in the entire study population as well as in various subgroups were estimated. Adverse events were recorded during the entire course of the study. A total number of 150 patients were enrolled by 15 Hungarian study sites. Out of these, 82 patients received 6 cycles of rituximab containing treatment. Overall response rates of 88.24% (CI: 81.6-93.12%) and 94.59% (CI: 86.73-98.51%) were recorded in the intent-to-treat (ITT) and per-protocol (PP) populations, respectively. In both study populations, somewhat higher ORR was observed in patients aged ≥65 years. Subgroups defined according to either chromosomal aberrations (presence of 11q and 17p deletions) showed apparently high ORRs, though these rates were most probably biased by low patient numbers. 144 adverse events were reported during the study, of which 15 AEs were considered to be related to the administration of rituximab. Analyses of the efficacy variables have revealed comparable results to those previously reported by controlled clinical trials.

摘要

慢性淋巴细胞白血病(CLL)是最常见的血液系统恶性肿瘤之一,其临床病程具有显著的异质性。在标准化疗中加入利妥昔单抗已被证明可提高初治CLL患者的缓解率并最终延长生存期。CILI是一项开放标签、非随机、单臂、多中心的观察性研究,旨在收集根据当前标签使用利妥昔单抗联合标准化疗的初治CLL患者的真实疗效数据。估计了整个研究人群以及各个亚组的总缓解率(ORR)。在研究的整个过程中记录不良事件。15个匈牙利研究地点共招募了150名患者。其中,82名患者接受了6个周期含利妥昔单抗的治疗。在意向性治疗(ITT)人群和符合方案(PP)人群中,总缓解率分别为88.24%(CI:81.6 - 93.12%)和94.59%(CI:86.73 - 98.51%)。在两个研究人群中,年龄≥65岁的患者观察到略高的ORR。根据染色体异常(11q和17p缺失的存在)定义的亚组显示出明显较高的ORR,尽管这些率很可能因患者数量少而有偏差。研究期间报告了144起不良事件,其中15起不良事件被认为与利妥昔单抗的给药有关。疗效变量分析显示结果与之前对照临床试验报告的结果相当。

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