节律性环磷酰胺和长春碱治疗难治性淋巴瘤

Filip Geurs, Luc Derveaux, Jelke Verwimp
{"title":"节律性环磷酰胺和长春碱治疗难治性淋巴瘤","authors":"Filip Geurs,&nbsp;Luc Derveaux,&nbsp;Jelke Verwimp","doi":"10.3816/CLM.2009.n.095","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>A recent phase I report drew attention to the effectiveness of metronomic (daily low-dose oral) CPA and I.V. vinblastine in refractory Hodgkin disease.<sup>1</sup> We used this combination in a patient with Hodgkin lymphoma and extensive prior treatment. The regimen was adapted to include rituximab for another patient who was unfit for R-CHOP (cyclophosphamide/doxorubicin/vincristine/prednisone plus rituximab) therapy due to prior myocardial infarction.</p></div><div><h3>Case 1</h3><p>A 56-year-old patient had first-line chemotherapy for Hodgkin lymphoma stage IVB in 2004, treated with ABVD (doxorubicin/bleomycin/vinblastine/dacarbazine). A year later a recurrence was treated with stem cell transplantation. He presented in February 2008 with extensive bone metastases, for which 45 Gy radiotherapy was given, also with curative intent. In April 2008 we started with metronomic chemotherapy (cyclophosphamide 50 mg + methylprednisolone 32 mg per day orally, vinblastine 3 mg/m<sup>2</sup> intravenously [I.V.] 1 × per week) for retroperitoneal lymph node recurrence. This treatment was well tolerated. After 9 months of treatment, there were no lymph nodes detectable on computed tomography scan. Complete remission now lasts &gt; 3 months.</p></div><div><h3>Case 2</h3><p>An 81-year-old farmer had a myocardial infarction 40 years ago. He presented with cutaneous involvement and axillary lymph node. Biopsy showed a cutaneous involvement by B-cell diffuse large-cell lymphoma. International Prognostic Index score was low. Ejection fraction was 42%. The same chemotherapy was applied (cyclophosphamide 50 mg/d and methylprednisolone 32 mg per day, vinblastine I.V. days 1, 8, 15), but on day 22 of the 28-day cycle, we applied rituximab 375 mg/m<sup>2</sup>. The patient had a complete remission after 4 months of treatment.</p></div><div><h3>Conclusion</h3><p>These data confirm the effectiveness of this well-tolerated regimen in refractory lymphoma as well as in a lymphoma patient unfit for anthracyclines.</p></div><div><h3>Reference</h3><p>Young S, Whissell M, Noble JC. Phase II clinical results involving treatment with low-dose daily oral cyclophosphamide, weekly vinblastine, and rofecoxib in patients with advanced solid tumors. <em>Clin Cancer Res</em> 2006; 12; 3092-9.</p></div>","PeriodicalId":100272,"journal":{"name":"Clinical Lymphoma and Myeloma","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3816/CLM.2009.n.095","citationCount":"0","resultStr":"{\"title\":\"Metronomic Cyclophosphamide and Vinblastine in Refractory Lymphoma\",\"authors\":\"Filip Geurs,&nbsp;Luc Derveaux,&nbsp;Jelke Verwimp\",\"doi\":\"10.3816/CLM.2009.n.095\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>A recent phase I report drew attention to the effectiveness of metronomic (daily low-dose oral) CPA and I.V. vinblastine in refractory Hodgkin disease.<sup>1</sup> We used this combination in a patient with Hodgkin lymphoma and extensive prior treatment. The regimen was adapted to include rituximab for another patient who was unfit for R-CHOP (cyclophosphamide/doxorubicin/vincristine/prednisone plus rituximab) therapy due to prior myocardial infarction.</p></div><div><h3>Case 1</h3><p>A 56-year-old patient had first-line chemotherapy for Hodgkin lymphoma stage IVB in 2004, treated with ABVD (doxorubicin/bleomycin/vinblastine/dacarbazine). A year later a recurrence was treated with stem cell transplantation. He presented in February 2008 with extensive bone metastases, for which 45 Gy radiotherapy was given, also with curative intent. In April 2008 we started with metronomic chemotherapy (cyclophosphamide 50 mg + methylprednisolone 32 mg per day orally, vinblastine 3 mg/m<sup>2</sup> intravenously [I.V.] 1 × per week) for retroperitoneal lymph node recurrence. This treatment was well tolerated. After 9 months of treatment, there were no lymph nodes detectable on computed tomography scan. Complete remission now lasts &gt; 3 months.</p></div><div><h3>Case 2</h3><p>An 81-year-old farmer had a myocardial infarction 40 years ago. He presented with cutaneous involvement and axillary lymph node. Biopsy showed a cutaneous involvement by B-cell diffuse large-cell lymphoma. International Prognostic Index score was low. Ejection fraction was 42%. The same chemotherapy was applied (cyclophosphamide 50 mg/d and methylprednisolone 32 mg per day, vinblastine I.V. days 1, 8, 15), but on day 22 of the 28-day cycle, we applied rituximab 375 mg/m<sup>2</sup>. The patient had a complete remission after 4 months of treatment.</p></div><div><h3>Conclusion</h3><p>These data confirm the effectiveness of this well-tolerated regimen in refractory lymphoma as well as in a lymphoma patient unfit for anthracyclines.</p></div><div><h3>Reference</h3><p>Young S, Whissell M, Noble JC. Phase II clinical results involving treatment with low-dose daily oral cyclophosphamide, weekly vinblastine, and rofecoxib in patients with advanced solid tumors. <em>Clin Cancer Res</em> 2006; 12; 3092-9.</p></div>\",\"PeriodicalId\":100272,\"journal\":{\"name\":\"Clinical Lymphoma and Myeloma\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2009-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.3816/CLM.2009.n.095\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Lymphoma and Myeloma\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1557919011700464\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Lymphoma and Myeloma","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1557919011700464","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

最近的一项I期报告引起了人们对节拍器(每日低剂量口服)CPA和长春花碱静脉注射治疗难治性霍奇金病的有效性的关注我们在霍奇金淋巴瘤患者和广泛的先前治疗中使用了这种组合。另一名因既往心肌梗死而不适合R-CHOP(环磷酰胺/阿霉素/长春新碱/泼尼松加利妥昔单抗)治疗的患者调整了方案,包括利妥昔单抗。病例1A, 56岁,2004年因霍奇金淋巴瘤IVB期接受一线化疗,采用ABVD(阿霉素/博来霉素/长春花碱/达卡巴嗪)治疗。一年后,复发患者接受干细胞移植治疗。他于2008年2月出现广泛的骨转移,给予45 Gy放射治疗,也有治疗目的。2008年4月,我们开始了节律化疗(环磷酰胺50 mg +甲基强的松龙32 mg/天口服,长春花碱3 mg/m2静脉滴注[1次/周]腹膜后淋巴结复发。这种治疗耐受性良好。治疗9个月后,计算机断层扫描未发现淋巴结。完全缓解现在持续>3个月。病例2:一位81岁的农民,40年前心肌梗塞。他表现为皮肤受累和腋窝淋巴结。活检显示b细胞弥漫性大细胞淋巴瘤累及皮肤。国际预后指数评分较低。射血分数为42%。应用相同的化疗(环磷酰胺50 mg/d,甲基强的松龙32 mg/d,长春花碱静脉注射第1、8、15天),但在28天周期的第22天,我们应用利妥昔单抗375 mg/m2。经过4个月的治疗,患者病情完全缓解。结论这些数据证实了这种耐受性良好的方案在难治性淋巴瘤以及不适合蒽环类药物治疗的淋巴瘤患者中的有效性。参考文献young S, Whissell M, Noble JC。II期临床结果包括低剂量每日口服环磷酰胺,每周长春碱和罗非昔布治疗晚期实体瘤患者。临床癌症研究2006;12;3092 - 9。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Metronomic Cyclophosphamide and Vinblastine in Refractory Lymphoma

Introduction

A recent phase I report drew attention to the effectiveness of metronomic (daily low-dose oral) CPA and I.V. vinblastine in refractory Hodgkin disease.1 We used this combination in a patient with Hodgkin lymphoma and extensive prior treatment. The regimen was adapted to include rituximab for another patient who was unfit for R-CHOP (cyclophosphamide/doxorubicin/vincristine/prednisone plus rituximab) therapy due to prior myocardial infarction.

Case 1

A 56-year-old patient had first-line chemotherapy for Hodgkin lymphoma stage IVB in 2004, treated with ABVD (doxorubicin/bleomycin/vinblastine/dacarbazine). A year later a recurrence was treated with stem cell transplantation. He presented in February 2008 with extensive bone metastases, for which 45 Gy radiotherapy was given, also with curative intent. In April 2008 we started with metronomic chemotherapy (cyclophosphamide 50 mg + methylprednisolone 32 mg per day orally, vinblastine 3 mg/m2 intravenously [I.V.] 1 × per week) for retroperitoneal lymph node recurrence. This treatment was well tolerated. After 9 months of treatment, there were no lymph nodes detectable on computed tomography scan. Complete remission now lasts > 3 months.

Case 2

An 81-year-old farmer had a myocardial infarction 40 years ago. He presented with cutaneous involvement and axillary lymph node. Biopsy showed a cutaneous involvement by B-cell diffuse large-cell lymphoma. International Prognostic Index score was low. Ejection fraction was 42%. The same chemotherapy was applied (cyclophosphamide 50 mg/d and methylprednisolone 32 mg per day, vinblastine I.V. days 1, 8, 15), but on day 22 of the 28-day cycle, we applied rituximab 375 mg/m2. The patient had a complete remission after 4 months of treatment.

Conclusion

These data confirm the effectiveness of this well-tolerated regimen in refractory lymphoma as well as in a lymphoma patient unfit for anthracyclines.

Reference

Young S, Whissell M, Noble JC. Phase II clinical results involving treatment with low-dose daily oral cyclophosphamide, weekly vinblastine, and rofecoxib in patients with advanced solid tumors. Clin Cancer Res 2006; 12; 3092-9.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信