The addition of rituximab to CHOP chemotherapy improves overall and failure-free survival for follicular grade 3 lymphoma
The addition of rituximab to CHOP chemotherapy improves overall and failure-free survival for follicular grade 3 lymphoma
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DOI：
10.1093/annonc/mdm511
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发表时间：
2008-03-01
影响因子：
50.5
通讯作者：
Fayad, L. E.
中科院分区：
文献类型：
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作者：
Overman, M. J.;Feng, L.;Fayad, L. E.
背景资料：利妥昔单抗蒽环类药物为基础的治疗滤泡性淋巴瘤3级的好处还没有studyed.Patients和方法：我们回顾性分析了45例滤泡性淋巴瘤3级谁与利妥昔单抗和环磷酰胺，多柔比星，长春新碱和泼尼松（CHOP）的组合治疗在得克萨斯大学医学博士安德森癌症中心的记录。反应率，无失败生存期（FFS），总生存期（OS）进行了估计和历史比较CHOP只治疗patients.Results：国际预后指数（IPI）分布为47%低，36%低中间，13%高中间，4%高风险。完全缓解率为96%。45名患者中有44人仍然活着。存活患者的中位随访时间为3.5年。根据IPI，低风险患者组的3年FFS率为80% [95%置信区间（CI）64%-100%]，低-中等风险患者组为81%（95% CI 64%-100%），高-中等/高风险患者组为50%（95% CI 25%-100%）。在CHOP基础上加用利妥昔单抗可改善5年FFS，71%（95% CI 58%至87%）与44%相比（95% CI 36%至55%），P值为0.019，5年OS为98%（95% CI 93%~ 100%）与75%（95% CI 67%~ 84%）比较，P值为0.0034。结论：CHOP方案加用利妥昔单抗有效率高，早期生存率高。尽管使用利妥昔单抗，低风险患者仍然表现出高失败率。
Background: The benefit of adding rituximab to anthracycline-based therapy for follicular lymphoma grade 3 has not been studied.Patients and methods: We retrospectively reviewed the records of 45 patients with follicular grade 3 lymphoma who were treated with rituximab and the combination of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) at The University of Texas MD Anderson Cancer Center. Response rate, failure-free survival (FFS), and overall survival (OS) were estimated and a historical comparison to CHOP-only-treated patients was made.Results: The International Prognostic Index (IPI) distribution was 47% low, 36% low intermediate, 13% high intermediate, and 4% high risk. The complete response rate was 96%. Forty-four of 45 patients are still alive. Median follow-up for the alive patients is 3.5 years. The 3-year FFS rate according to the IPI was 80% [95% confidence interval (CI) 64% to 100%] in low, 81% in low intermediate (95% CI 64% to 100%), and 50% (95% CI 25% to 100%) in high-intermediate/high-risk patient group. The addition of rituximab to CHOP improved both 5-year FFS, 71% (95% CI 58% to 87%) compared with 44% (95% CI 36% to 55%) with P value of 0.019, and 5-year OS, 98% (95% CI 93% to 100%) compared with 75% (95% CI 67% to 84%) with P value of 0.0034.Conclusion: The addition of rituximab to CHOP provided a high response rate and excellent early survival. Poor-risk patients continue to demonstrate a high rate of failure despite the use of rituximab.