Fludarabine: an effective treatment in patients with splenic lymphoma with villous lymphocytes
Fludarabine: an effective treatment in patients with splenic lymphoma with villous lymphocytes
复制标题
氟达拉滨：绒毛淋巴细胞脾淋巴瘤患者的有效治疗方法
作者：
F. Lefrère;O. Hermine;C. Belanger;S. François;H. Tilly;Lebas de La Cour Jc;F. Valensi;B. Varet;X. Troussard
脾淋巴细胞绒毛淋巴瘤(SLVL)是一种慢性B细胞性淋巴增生性疾病。脾切除和/或氯氨丁苯通常被认为是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。在一项回顾性研究中，我们评估了氟达拉滨(FDR)对10例SLVL患者的疗效和毒性。从诊断到治疗的中位时间为17个月(范围1-30个月)。此前有两名患者未接受治疗。化疗剂量25 /m2/d，静脉滴注5d，中位化疗周期2~6个周期。所有患者均可评估：5例患者在中位随访14个月(5-31个月)后获得良好且持续的反应，2例患者获得良好反应，但在15个月和36个月的随访后复发。每三个部分应答者中就有一个有持续的反应。治疗耐受性良好。对于脾切除术后复发或对CLB耐药的患者，FDR似乎是一种有效的治疗方法，具有良好的毒副作用。此外，它可能成为老年患者脾切除术的替代方案。为了证实我们的发现，有必要进行更长时间的随访和对更多患者的研究。
Splenic lymphoma with villous lymphocytes (SLVL) is a B cell chronic lymphoproliferative disorder. Splenectomy and/or chlorambucil are usually regarded as the most effective treatment in SLVL patients. However, a few patients relapse and the second-line treatment remains questionable. In a retrospective study, we evaluated the efficacy and toxicity of fludarabine (FDR) in 10 SLVL patients. The median duration between diagnosis and treatment was 17 months (range, 1–30). Two patients were previously untreated. The patients received FDR 25 mg/m2/day by venous infusion for 5 days with a median of four cycles of chemotherapy (range, 2–6). All patients were assessable: five patients achieved a good and persistent response after a median follow-up of 14 months (5–31), two achieved a good response but relapsed after a follow-up of 15 and 36 months. One out of the three partial responders have a persistent response. The treatment was well tolerated. FDR appears to be an efficient therapy with a favorable toxicity profile for patients in relapse after splenectomy or resistant to CLB. Furthermore it could constitute an alternative to splenectomy in older patients. A longer follow-up and the study of a larger group of patients are warranted to confirm our findings.