What is new in lymphoma?
What is new in lymphoma?
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DOI：
10.3322/canjclin.54.5.260
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发表时间：
2004-09-01
影响因子：
254.7
通讯作者：
Cheson, BD
中科院分区：
文献类型：
--
作者：
Cheson, BD
淋巴瘤是一组不同的恶性疾病，其在分子特征、遗传学、临床表现、治疗方法和结果方面各不相同。在过去几年中，我们对这些疾病的生物学理解取得了重大进展，导致世界卫生组织普遍采用的分类系统。新的治疗方法有可能改善患者的预后，国际预后指数和标准化反应标准有助于临床试验的解释。最值得注意的是，嵌合抗CD 20单克隆抗体利妥昔单抗改变了我们对B细胞疾病的治疗模式。这种抗体与化疗和其他生物制剂的组合在治疗淋巴瘤中显示出希望。其他抗体、放射免疫偶联物（如Y-90替伊莫单抗和1-131托西莫单抗）和奥贝默森钠（一种BCL-2反义寡核苷酸）都显示出前景。新的化疗方案如博来霉素、依托泊苷、阿霉素、环磷酰胺、长春新碱、甲基苄肼和泼尼松（BEACOPP）、药物如吉西他滨和针对CD 30的单克隆抗体也在霍奇金淋巴瘤中进行研究。临床研究的挑战是优化这些药物的使用，选择最有可能反应的患者，并基于合理的科学理性开发多靶向策略，从而提高淋巴瘤患者的治愈率。
The lymphomas are a diverse group of malignant disorders that vary with respect to their molecular features, genetics, clinical presentation, treatment approaches, and outcome. Over the past few years, there have been major advances in our understanding of the biology of these diseases, leading to a universally adopted World Health Organization classification system. New therapies are now available with the potential to improve patient outcome, and the International Prognostic Index and standardized response criteria help make clinical trials interpretable. Most notably, the chimeric antiCD20 monoclonal antibody rituximab has altered our therapeutic paradigms for B-cell disorders. Combinations of this antibody with chemotherapy and other biologic agents have shown promise in treating lymphoma. Other antibodies, radioimmunoconjugates (such as Y-90 ibritumomab tiuxetan and 1-131 tositumomab), and oblimerson sodium (a BCL-2 antisense oligonucleotide) have all shown promise. New chemotherapy regimens such as bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP), agents such as gemcitabine, and monoclonal antibodies directed against CD30 are also being studied in Hodgkin Lymphoma. The challenge of clinical research is to optimize the use of these agents, select patients most likely to respond, and develop multitargeted strategies based on sound scientific rational, with the potential to increase the cure rate of patients with lymphomas.