Prolonged myelosuppression with clofarabine in the treatment of patients with relapsed or refractory, aggressive non-Hodgkin lymphoma.
Prolonged myelosuppression with clofarabine in the treatment of patients with relapsed or refractory, aggressive non-Hodgkin lymphoma.
复制标题
氯法拉滨长期骨髓抑制治疗复发性或难治性侵袭性非霍奇金淋巴瘤患者。
DOI：
10.1080/10428190902730227
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发表时间：
2009
影响因子：
2.6
通讯作者：
Byrd,JohnC
中科院分区：
文献类型：
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作者：
Blum,KristieA;Hamadani,Mehdi;Phillips,GaryS;Lozanski,Gerard;Johnson,AmyJ;Lucas,DavidM;Smith,LisaL;Baiocchi,Robert;Lin,ThomasS;Porcu,Pierluigi;Devine,StevenM;Byrd,JohnC
我们评估了嘌呤核苷类似物氯法拉滨治疗复发性或难治性弥漫性大B细胞淋巴瘤（DLBCL）和套细胞淋巴瘤（MCL）患者的安全性和有效性。6例DLBCL（n= 5）或MCL（n= 1）患者，中位年龄为68岁，接受氯法拉滨40 mg/m2 IV 2 h，持续5 d，每28 d重复，持续1-2个周期。总缓解率为50%（完全缓解= 1，未确认的完全缓解= 1，部分缓解= 1）。中位无进展生存期为3.5个月（范围1.5-10个月），中位总生存期为7.8个月（范围3-31个月）。3-4级中性粒细胞减少症和血小板减少症是普遍的，中性粒细胞和血小板恢复所需的中位时间分别为34（范围19-55）天和77（范围0-275）天。3级非血液学毒性包括转氨酶升高、发热性中性粒细胞减少、非血小板减少性感染和体位性低血压。由于6例患者中有5例发生3-4级骨髓抑制延长和体位性低血压，终止了研究的进一步入组。氯法拉滨在复发性或难治性DLBCL中表现出单药活性的证据。然而，需要进一步研究新的给药方案，以维持这种疗效并限制毒性。
We evaluated the safety and efficacy of the purine nucleoside analogue, clofarabine, in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) and mantle cell lymphoma (MCL). Six patients with DLBCL (n= 5) or MCL (n= 1) and a median age of 68 years were treated with 40 mg/m2clofarabine IV over 2 h for 5 days, repeated every 28 days, for 1–2 cycles. The overall response rate was 50% (complete response = 1, complete response unconfirmed = 1, partial response = 1). Median progression-free survival was 3.5 months (range 1.5–10 months) and the median overall survival was 7.8 months (range 3–31 months). Grade 3–4 neutropenia and thrombocytopenia was universal, with a median of 34 (range 19–55) and 77 (range 0–275) days required for neutrophil and platelet recovery. Grade 3 non-hematologic toxicities included transaminitis, febrile neutropenia, non-neutropenic infections and orthostatic hypotension. Further accrual to the study was terminated due to prolonged Grade 3–4 myelosuppression and orthostatic hypotension in five of six patients. Clofarabine exhibits evidence of single agent activity in relapsed or refractory DLBCL. However, further study with novel administration schedules that maintain this efficacy and limit toxicity is warranted.