Pigaditou A, Rohatiner A Z, Whelan J S, Johnson P W, Ganjoo R K, Rossi A, Norton A J, Amess J, Lim J, Lister T A
ICRF Department of Medical Oncology, St Bartholomews Hospital, London, UK.
Semin Oncol. 1993 Oct;20(5 Suppl 7):24-7.
During the last 4 years, 88 patients with low-grade non-Hodgkin's lymphoma have received fludarabine, 25 mg/m2 daily for 5 days, repeated every 3 to 4 weeks. Fifty-one patients received fludarabine at recurrence or when the disease was deemed resistant to conventional treatment, 21 patients received the drug in the context of "minimal residual disease" in the hope of complete remission being achieved with a view to proceeding to myeloablative therapy (cyclophosphamide and total body irradiation) with autologous bone marrow transplantation, and 16 newly diagnosed patients received fludarabine as first-line therapy. Myelosuppression was the predominant toxicity, with 55% and 31% of previously treated and newly diagnosed patents, respectively, becoming neutropenic (neutrophils < or = 1.0 X 10(9)/L). The response rate (complete and partial response) was 44% for both patients with recurrent/resistant disease (20 of 45 evaluable patients) and for those with "minimal residual disease" (nine of 20 evaluable patients). In newly diagnosed patients, the response rate was 69% (11 of 16 patients). Five patients died of infection while neutropenic. These results confirm the activity of fludarabine in low-grade non-Hodgkin's lymphoma. Its precise role remains to be determined.
在过去4年中，88例低度非霍奇金淋巴瘤患者接受了氟达拉滨治疗，剂量为每日25mg/m²，连用5天，每3至4周重复一次。51例患者在复发时或疾病被认为对传统治疗耐药时接受氟达拉滨治疗，21例患者在“微小残留病”情况下接受该药治疗，以期实现完全缓解，进而进行自体骨髓移植的清髓性治疗（环磷酰胺和全身照射），16例新诊断患者接受氟达拉滨作为一线治疗。骨髓抑制是主要毒性反应，既往接受过治疗的患者和新诊断患者中分别有55%和31%出现中性粒细胞减少（中性粒细胞<或=1.0×10⁹/L）。复发/耐药患者（45例可评估患者中的20例）和“微小残留病”患者（20例可评估患者中的9例）的缓解率（完全缓解和部分缓解）均为44%。新诊断患者的缓解率为69%（16例患者中的11例）。5例患者在中性粒细胞减少期间死于感染。这些结果证实了氟达拉滨在低度非霍奇金淋巴瘤中的活性。其确切作用仍有待确定。
