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原发性纵隔大 B 细胞淋巴瘤每 21 天或 14 天接受利妥昔单抗 CHOP 治疗的真实体验。

Real-life Experience With Rituximab-CHOP Every 21 or 14 Days in Primary Mediastinal Large B-cell Lymphoma.

机构信息

Third Department of Internal Medicine and Laboratory, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece.

Department of Hematology and Lymphoma, Evangelismos General Hospital, Athens, Greece.

出版信息

In Vivo. 2022 May-Jun;36(3):1302-1315. doi: 10.21873/invivo.12831.

Abstract

BACKGROUND/AIM: Primary mediastinal large B-cell lymphoma (PMLBCL) is an aggressive B-cell non-Hodgkin lymphoma (NHL), whose prognosis has greatly improved since the incorporation of the anti-CD20 monoclonal antibody rituximab into current therapeutic regimens. Evidence, however, on the optimal time interval between consecutive chemoimmunotherapy (CIT) cycles is still scarce. This study aimed to evaluate the efficacy outcomes of the more commonly administered 3-weekly regimens to the biweekly ones in a PMLBCL patients' population, who were mostly treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone every 21 days (R-CHOP-21) or R-CHOP-14.

PATIENTS AND METHODS

We retrospectively studied our cohort of consecutively treated PMLBCL patients, focusing on their treatment density, in order to determine possible differences in treatment outcomes.

RESULTS

CIT, in the form of both R-CHOP-21 as well as R-CHOP-14 (or similar regimens), is highly active in PMLBCL, with low rates of early treatment failure. In our cohort of patients, R-CHOP-14 did not result in a meaningful improvement of freedom from progression (FFP) or overall survival (OS).

CONCLUSION

Both R-CHOP-14 and R-CHOP-21 are probably equally effective in PMLBCL, yet further, prospective, randomized studies are warranted to clarify whether dose-dense regimens can be associated with better disease control and long-term results.

摘要

背景/目的:原发性纵隔大 B 细胞淋巴瘤(PMLBCL)是一种侵袭性 B 细胞非霍奇金淋巴瘤(NHL),自从将抗 CD20 单克隆抗体利妥昔单抗纳入当前的治疗方案以来,其预后有了很大改善。然而,关于连续化疗免疫治疗(CIT)周期之间最佳时间间隔的证据仍然很少。本研究旨在评估在接受利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松龙每 21 天(R-CHOP-21)或 R-CHOP-14 治疗的 PMLBCL 患者人群中,更常见的 3 周方案与双周方案相比的疗效结果,这些患者大多接受了上述方案治疗。

患者和方法

我们回顾性研究了连续治疗的 PMLBCL 患者队列,重点关注他们的治疗密度,以确定治疗结果是否存在差异。

结果

CIT 以 R-CHOP-21 和 R-CHOP-14(或类似方案)的形式在 PMLBCL 中非常有效,早期治疗失败的比例较低。在我们的患者队列中,R-CHOP-14 并没有显著改善无进展生存(FFP)或总生存(OS)。

结论

R-CHOP-14 和 R-CHOP-21 可能在 PMLBCL 中同样有效,但需要进一步的前瞻性随机研究来阐明密集剂量方案是否可以与更好的疾病控制和长期结果相关。

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