Treatment of patients with low-grade B-cell lymphoma with the combination of chimeric anti-CD20 monoclonal antibody and CHOP chemotherapy
Treatment of patients with low-grade B-cell lymphoma with the combination of chimeric anti-CD20 monoclonal antibody and CHOP chemotherapy
复制标题
DOI：
10.1200/jco.1999.17.1.268
复制
发表时间：
1999-01-01
影响因子：
45.3
通讯作者：
Varns, C
中科院分区：
文献类型：
--
作者：
Czuczman, MS;Grillo-López, AJ;Varns, C
目的：确定嵌合抗CD20抗体利妥昔单抗（Rituximab，IDEC - C2B8；IDEC制药公司，圣地亚哥，加利福尼亚州）与环磷酰胺、阿霉素、长春新碱和泼尼松（CHOP）化疗联合使用的安全性和有效性。
患者与方法：40例低度或滤泡性B细胞非霍奇金淋巴瘤患者接受6次利妥昔单抗输注（每次剂量375mg/m²），同时联合6个疗程的CHOP化疗。
结果：总有效率为95%（40例患者中的38例）。22例患者完全缓解（55%），16例患者部分缓解（40%），2例未接受治疗的患者被归类为无应答者。在中位观察时间29 +个月后，缓解持续时间和进展时间的中位数尚未达到。38例可评估患者中有28例（74%）在中位随访期间持续缓解。CHOP导致的最常见不良事件为脱发（38例患者）、中性粒细胞减少（31例患者）和发热（23例患者）。利妥昔单抗导致的最常见事件为发热和寒战，主要在首次输注时观察到。未检测到针对嵌合抗体的可量化免疫反应。在18例患者的亚组中，8例患者bcl - 2[t(14;18)]易位呈阳性；其中7例患者完全缓解，并在治疗完成时转为聚合酶链反应（PCR）阴性。
结论：这是首次报道证明利妥昔单抗抗CD20嵌合抗体与标准剂量全身化疗联合用于治疗惰性B细胞淋巴瘤的安全性和有效性。临床反应表明联合使用具有相加的治疗益处，且无明显增加的毒性。血液和/或骨髓中bcl - 2通过PCR从阳性转为阴性表明可能清除了微小残留疾病，这是以前单独使用CHOP化疗所未显示的。
《临床肿瘤学杂志》17:268 - 216，（C）1999年美国临床肿瘤学会
Purpose: To determine the safety and efficacy of the combination of the chimeric anti-CD20 antibody Rituxan (Rituximab, IDEC-C2B8; IDEC Pharmaceuticals Corporation, San Diego, CA), and cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy.Patients and Methods: Forty patients with low-grade or follicular B-cell non-Hodgkin's lymphoma received six infusions of Rituxan (375 mg/m(2) per dose) in combination with six doses of CHOP chemotherapy.Results: The overall response rate was 95% (38 of 40 patients). Twenty-two patients experienced a complete response (55%), 16 patients had a partial response (40%), and two patients, who received no treatment, were classified as nonresponders. Medians for duration of response and time to progression had not been reached after a median observation time of 29 + months, Twenty-eight of 38 assessable patients (74%) continued in remission during this median follow-vp period. The most frequent adverse events attributable to CHOP were alopecia (38 patients), neutropenia (31 patients), and fever (23 patients). The most frequent events attributed to Rituxan were fever and chills, observed primarily with the first infusion. No quantifiable immune response to the chimeric antibody was detected. In a subset of 18 patients, the bcl-2 [t(14;18)] translocation was positive in eight patients; seven of these patients herd complete remissions and converted to polymerase chain reaction (PCR) negativity by completion of therapy.Conclusion: This is the first report demonstrating the safety and efficacy of Rituxan anti-CD20 chimeric antibody in combination with standard-dose systemic chemotherapy in the treatment of indolent B-cell lymphoma. The clinical responses suggest an additive therapeutic benefit for the combination with no significant added toxicity. The conversion of bcl-2 from positive to negative by PCR in blood and/or marrow suggests possible clearing of minimal residual disease nat previously demonstrated by CHOP chemotherapy alone.J Clin Oncol 17:268-216, (C) 1999 by American Society of Clinical Oncology.