Bendamustine as monotherapy and in combination regimens for the treatment of diffused large B-cell lymphoma
Bendamustine as monotherapy and in combination regimens for the treatment of diffused large B-cell lymphoma
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苯达莫司汀作为单一疗法和联合疗法治疗弥漫性大 B 细胞淋巴瘤
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通讯作者：
Ling Jiang
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作者：
Weiqing Ruan;Wei Meng;Lan Deng;Joseph Ye;Ling Jiang
目的：对于患有弥漫性大 B 细胞淋巴瘤 (DLBCL) 且因心脏病而无法接受含阿霉素化疗的患者，可选择的治疗方案有限。我们用苯他莫司汀和利妥昔单抗治疗这些患者。我们还进行了用苯达莫司汀治疗 DLBCL 细胞系的体外实验。本研究的目的是评估苯达莫司汀对 DLBCL 患者和细胞系的疗效。方法。已确诊患有 DLBCL 且患有严重心脏病的患者在每个 21 天周期的第 1 天接受利妥昔单抗 375 mg/m2 治疗，在每个 21 天周期的第 1 天和第 2 天接受苯达莫司汀 100 mg/m2 治疗，共 6 个周期。通过 PET/CT 扫描评估治疗反应。用浓度为100μMol/L的苯达莫司汀处理人DLBCL细胞系OCI-LY8和RJ-LY1。评估细胞活力、细胞凋亡诱导、mRNA 和蛋白质表达。结果：连续 3 名患者接受治疗，经过 6 个周期的苯达莫司汀和利妥昔单抗治疗后获得完全缓解 (CR)。副作用是可以控制的。体外研究发现，苯达莫司汀治疗的DLBCL细胞活力下降，诱导晚期凋亡，caspase-3和caspase-8的mRNA和蛋白表达增加，但BCL-2表达下降。结论。利妥昔单抗和苯达莫司汀联合治疗具有抗DLBCL活性，可能成为与蒽环类药物相矛盾的患者的一线治疗。
Purpose.Limited treatment options are available for patients with diffuse large B cell lymphoma (DLBCL) and unable to have Adriamycin-containing chemotherapy due to cardiac disease. We treated those patients with Bentamustine and Rituximab. We also conducted in vitro experiments to treatment DLBCL cell line with Bendamustine. The purpose of this study was to assess the effecacy of bendamustine in DLBCL patients and cell lines..Methods.Patients, who has been confirmed to have DLBCL, with severe cardiac disease were treated with Rituximab 375 mg/m2 on day 1 and Bendamustine 100 mg/m2 on day 1 and 2 of each 21-day cycle for a total of 6 cycles. Response to therapy was assessed by PET/CT scan. Human DLBCL cell line OCI-LY8 and RJ-LY1 were treated with bendamustine at the concentration of 100μMol/L. Cell viability, apoptosis induction, mRNA and protein expression were evaluated. .Results.Three consecutive patients were treated and had reveived complete remission (CR) after 6 cycles of bendamustine and rituximab treatment. The side effects were manageable. In vitro study, we found that Bendamustine treated DLBCL cells has decreased in viability, induced late apopotosis, increased in caspase-3 and caspase-8 but decreased in BCL-2 expression on mRNA and protein..Conclusion .The combination of Rituximab and Bendamustine has activity against DLBCL and could be potential first line therapy for patients who are contradicted with anthracycline.