Lack of Efficacy of 2-Chlorodeoxyadenoside in the Treatment of Splenic Lymphoma with Villous Lymphocytes
Lack of Efficacy of 2-Chlorodeoxyadenoside in the Treatment of Splenic Lymphoma with Villous Lymphocytes
复制标题
2-氯脱氧腺苷治疗绒毛淋巴细胞脾淋巴瘤缺乏疗效
作者：
F. Lefrère;O. Hermine;S. François;G. Panelatti;F. Valensi;B. Grosbois;J. Misset;B. Varet;X. Troussard
脾淋巴瘤伴绒毛淋巴细胞（SLVL）是一种b细胞慢性淋巴细胞增生性疾病。脾切除术和/或氯霉素（CLB）通常被认为是SLVL患者最有效的治疗方法。然而，少数患者复发，二线治疗仍然值得怀疑。虽然2-Cda已经在慢性淋巴细胞白血病（CLL）和毛细胞白血病（HCL）患者中进行了评估，但仅有一例报道将其作为SLVL的治疗方法。因此，我们对7例SLVL患者进行了疗效和毒性评价。从诊断到治疗的中位持续时间为18个月（范围为1至59个月）。患者接受2- cda （0.1 mg/kg/d）静脉输注，为期7天，中位数为1个周期（范围，1 - 2），作为一线治疗（1例患者）或在其他治疗（脾切除术，化疗）失败后。两名患者获得完全缓解。第1例随访9个月，CR维持正常，后复发；第二例患者在随访20个月后仍处于CR状态。4例患者在中位随访3.5个月（1至4个月）后获得部分缓解并复发。一名患者没有反应。这种治疗在许多感染事件中耐受性不佳。在我们的研究范围内，2-Cda似乎不是SLVL的有效治疗方法，并且对于脾切除术后复发或对CLB有抵抗力的患者耐受性不好。
Splenic lymphoma with villous lymphocytes (SLVL) is a B-cell chronic lymphoproliferative disorder. Splenectomy and/or chlorambucil (CLB) are usually regarded as the most effective treatment in SLVL patients. However, a few patients relapse and the second line therapy remains questionable. Although 2-Cda has been evaluated in patients with chronic lymphoid leukemia (CLL) and hairy cell leukemia (HCL), it has been reported as the treatment of SLVL in only one case report. Therefore, we have evaluated its efficacy and toxicity in 7 SLVL patients. The median duration between diagnosis and treatment was 18 months (range, 1 to 59). The patients received 2-CdA (0.1 mg/kg/d) by venous infusion for 7 days with a median number of 1 cycle (range, 1 to 2) either as a first line therapy (one patient) or after a failure of other therapies (splenectomy, chemotherapy). Two patients achieved a complete response. The first one maintained his CR during a follow-up of 9 months and then relapsed; the second patient remained in CR after a follow-up of 20 months. Four patients achieved a partial response and relapsed after a median follow-up of 3.5 months (range, 1 to 4). One patient had no response. The treatment was not well tolerated with many infectious events. In the limits of our study, 2-Cda does not appear to be efficient therapy for SLVL and is not well tolerated for patients in relapse after splenectomy or resistant to CLB.