复发性或难治性弥漫大B细胞淋巴瘤二线化疗伊福酰胺-卡铂-依托泊苷联合或不联合利妥昔单抗的疗效

Mymensingh medical journal : MMJ Pub Date : 2024-10-01
S Haque, Z Z Chowdhury, T Bahar, S T Reshma, A K M Islam, M Ali, M M Rahman
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引用次数: 0

摘要

复发或难治的弥漫大B细胞淋巴瘤很难治疗。新发弥漫大B细胞淋巴瘤的预后优于转化的弥漫大B细胞淋巴瘤。对于复发或难治性弥漫大 B 细胞淋巴瘤患者来说,CHOP 或类似方案的反应在决定对挽救疗法的反应方面起着重要作用。对初始治疗无反应的患者对复发治疗产生反应的几率很低。这是一项小规模观察研究,于 2017 年 1 月至 2020 年 12 月在孟加拉国国立癌症研究所和医院进行。国立癌症研究所和医院的血液科共发现了34名复发或难治性弥漫大B细胞淋巴瘤患者,其中28人接受了ICE化疗,6人接受了R-ICE化疗作为二线方案。二线化疗的总反应率为 64.8%,其中 32.4%(11 名患者)完全缓解,32.4%(11 名患者)部分缓解。二线疗法的中位总生存期为10个月,4年总生存期为32.4%,4年无进展生存期为17.6%。疾病稳定/疾病进展患者的中位总生存期为7个月,而完全缓解患者的中位总生存期为15个月,部分缓解患者的中位总生存期为9个月(P2(P=0.010))。然而,利用新药提高挽救疗效是当务之急。有必要开展进一步研究,以确定该疗法是否能改善复发或难治性弥漫大B细胞淋巴瘤患者的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Outcome of Relapsed or Refractory Diffuse Large B-cell Lymphoma with Second-line Chemotherapy Ifosfamide-Carboplatin-Etoposide with or without Rituximab.

Treatment of relapsed or refractory diffuse large B-cell lymphoma is difficult. The de novo diffuse large B-cell lymphoma has better prognosis than the transformed diffuse large B-cell lymphoma. The response of CHOP or a similar regimen has an important role in determining response to salvage therapy, in relapse or refractory diffuse large B-cell lymphoma patients. Patients who are non-responder to initial treatment have a very poor chance of responding to therapy for relapse. This was a small scale observational study and was conducted from January 2017 to December 2020 in National Institute of Cancer Research and Hospital, Bangladesh. A total of 34 patients with relapsed or refractory diffuse large B-cell lymphoma were identified at hematology department in National Institute of Cancer Research and Hospital, 28 of them were treated with ICE chemotherapy and 6 with R-ICE chemotherapy as second line regimen. Overall response rate to 2nd line chemotherapy was 64.8%, with 32.4% (11 patients) complete remission and 32.4% (11 patients) partial remission. Median overall survival to second line regimen was 10 months, corresponding to a 4 year overall survival of 32.4% and a 4 year progression free survival was 17.6%. Patient with stable disease/progressive disease median overall survival was 7 months compared with 15 months for complete remission and 9 months for partial remission (p<0.001). Median overall survival was significantly better in patients with international prognostic index 0-2 compared in those with international prognostic index >2 (p=0.010). However improvement of salvage efficacy is an urgent need with new drugs. Further studies are necessary to determine whether this regimen will improve outcomes of relapsed or refractory diffuse large B-cell lymphoma patients.

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