Risk Factors for Skin Toxicities Associated with Bendamustine-Based Chemotherapy in Patients with Non-Hodgkin Lymphoma
Risk Factors for Skin Toxicities Associated with Bendamustine-Based Chemotherapy in Patients with Non-Hodgkin Lymphoma
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DOI：
10.1248/bpb.b20-00428
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发表时间：
2020-10-01
影响因子：
2
通讯作者：
Nakamura, Tsutomu
中科院分区：
文献类型：
--
作者：
Uchida, Mayako;Mori, Yasuhiro;Nakamura, Tsutomu
苯达莫司汀在治疗非霍奇金淋巴瘤 (NHL) 方面发挥着特别重要的作用。然而，单独使用苯达莫司汀或与利妥昔单抗 (BR) 联合使用的患者可能会出现与药物相关的皮肤毒性，从而通过身体不适和心理困扰深刻影响他们与健康相关的生活质量。此外，皮肤症状恶化可能导致癌症化疗治疗的剂量减少或终止。我们回顾性地调查了接受苯达莫司汀单独治疗或 BR 治疗的 NHL 患者病历中的患者背景和治疗前特征，并确定了化疗开始时皮肤毒性的预测因素。如果患者年满20岁，诊断为NHL，并于2011年4月1日至2018年3月31日期间在神户市医疗中心综合医院血液科接受过苯达莫司汀单药治疗或BR治疗，则有资格参加该研究。该研究包括95名新诊断或难治性或复发性NHL患者。向后选择的多变量逐步逻辑回归分析显示，基线非既往化疗（比值比（OR），15.72；95%置信区间（CI），4.24-83.13，p < 0.001）是影响皮肤毒性发生的重要因素。我们的结果表明，对于接受单独苯达莫司汀或 BR 治疗的 NHL 患者，非既往化疗是皮肤毒性的一个重要危险因素。没有患者出现 3 级或以上的严重副作用，苯达莫司汀作为一线治疗非常有用。
Bendamustine plays an especially important role as a treatment for non-Hodgkin lymphoma (NHL). However, patients administered bendamustine alone or in combination with rituximab (BR) may experience drug-associated skin toxicities that can profoundly impact their health-related QOL through both physical discomfort and psychological distress. Moreover, worsening skin symptoms may lead to dose reduction or termination in the management of cancer chemotherapy. We retrospectively investigated patient backgrounds and pretreatment characteristics from medical records of NHL patients treated with bendamustine alone or BR therapy and identified predictive factors for skin toxicities at the start of chemotherapy. Patients were eligible for the study if they were 20 years older, diagnosed with NHL, and received bendamustine alone or BR therapy at the Department of Hematology, Kobe City Medical Center General Hospital, between April 1, 2011, and March 31, 2018. This study included 95 patients with newly diagnosed or refractory or relapsed NHL. Multivariate stepwise logistic regression analysis with backward selection revealed that baseline non-prior chemotherapy (odds ratio (OR), 15.72; 95% confidence interval (CI), 4.24-83.13, p < 0.001) was a significant factor influencing the occurrence of skin toxicity. Our results demonstrated that non-prior chemotherapy was a significant risk factor for skin toxicities in patients with NHL receiving bendamustine alone or BR therapy. No patient experience serious side effects of grade 3 or higher and that bendamustine is very useful as a first-line treatment.