Immunochemotherapy with rituximab and cyclophosphamide, doxorubicin, vincristine, and prednisone significantly improves response and time to treatment failure, but not long-term outcome in patients with previously untreated mantle cell lymphoma:: Results of a prospective randomized trial of the German low grade lymphoma study group (GLSG)
Immunochemotherapy with rituximab and cyclophosphamide, doxorubicin, vincristine, and prednisone significantly improves response and time to treatment failure, but not long-term outcome in patients with previously untreated mantle cell lymphoma:: Results of a prospective randomized trial of the German low grade lymphoma study group (GLSG)
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DOI：
10.1200/jco.2005.08.133
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发表时间：
2005-03-20
影响因子：
45.3
通讯作者：
Hiddemann, W
中科院分区：
文献类型：
--
作者：
Lenz, G;Dreyling, M;Hiddemann, W
目的：套细胞淋巴瘤（MCL）是一种预后差、对化疗敏感性低至中等、中位生存期仅3 ~ 4年的恶性淋巴瘤。为了改善结果，德国低度淋巴瘤研究组（GLSG）启动了一项随机试验，比较环磷酰胺、多柔比星、长春新碱、和泼尼松（CHOP）和利妥昔单抗（R-CHOP）与CHOP单独作为一线治疗晚期MCL。60）或R-CHOP（n = 62）。达到部分或完全缓解的65岁以下患者接受第二次随机分组，接受清髓性放化疗，随后进行自体干细胞移植或干扰素α维持治疗（IFN α）。结果R-CHOP在总有效率（94%v75%; P = 0.0054）、完全缓解率（34%v7%; P = 0.00024）和治疗失败时间（TTF;中位数，21 v14个月; P = 0.0131）方面明显上级优于CHOP。无进展生存期无差异。结论R-CHOP联合免疫化疗与单纯化疗相比，有效率明显提高，TTF延长。因此，R-CHOP可作为晚期MCL的新基线方案，但需要通过新的缓解策略进一步改进。(c)2005年，美国临床肿瘤学会。
Purpose Mantle cell lymphoma (MCL) is characterized by a poor prognosis with a low to moderate sensitivity to chemotherapy and a median survival of only 3 to 4 years. In an attempt to improve outcome, the German Low Grade Lymphoma Study Group (GLSG) initiated a randomized trial comparing the combination of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) and rituximab (R-CHOP) with CHOP alone as first-line therapy for advanced-stage MCL.Patients and Methods One hundred twenty-two previously untreated patients with advanced-stage MCL were randomly assigned to six cycles of CHOP (n = 60) or R-CHOP (n = 62). Patients up to 65 years of age achieving a partial or complete remission underwent a second randomization to either myeloablative radiochemotherapy followed by autologous stem-cell transplantation or interferon alfa maintenance (IFN alpha). All patients older than 65 years received lFN alpha maintenance.Results R-CHOP was significantly superior to CHOP in terms of overall response rate (94% v 75%; = .0054), complete remission rate (34% v7%; P = .00024), and time to treatment failure (TTF; median, 21 v 14 months; P = .0131). No differences were observed for progression-free survival. Toxicity was acceptable, with no major differences between the two therapeutic groups.Conclusion The combined immunochemotherapy with R-CHOP resulted in a significantly higher response rate and a prolongation of the TTF as compared with chemotherapy alone. Hence, R-CHOP may serve as a new baseline regimen for advanced stage MCL, but needs to be further improved by novel strategies in remission. (c) 2005 by American Society of Clinical Oncology.