THP-COP regimen for the treatment of peripheral T-cell lymphoma and adult T-cell leukemia/lymphoma: a multicenter phase II study
THP-COP regimen for the treatment of peripheral T-cell lymphoma and adult T-cell leukemia/lymphoma: a multicenter phase II study
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DOI：
10.1111/j.1600-0609.2010.01411.x
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发表时间：
2010-05-01
影响因子：
3.1
通讯作者：
Tamura, Kazuo
中科院分区：
文献类型：
--
作者：
Takamatsu, Yasushi;Suzumiya, Junji;Tamura, Kazuo
目的：吡拉西坦（THP）-COP与环磷酰胺+多柔比星+长春新碱+泼尼松龙（CHOP）在老年淋巴瘤患者中的疗效进行了比较。亚组分析显示，T细胞淋巴瘤与THP-COP有显著更好的反应，而在B细胞淋巴瘤中没有观察到这种差异。本研究的目的是证实THP-COP治疗T细胞淋巴瘤的疗效。方法：我们进行了一项多中心II期研究THP-COP作为T细胞淋巴瘤的一线治疗。分析总有效率、生存期和毒副反应。结果：53例患者入组本研究。17例患者患有外周T细胞淋巴瘤（PTCL），包括9例未另行说明的PTCL（PTCL-NOS）和8例血管免疫母细胞性T细胞淋巴瘤（AITL）。成人T细胞白血病/淋巴瘤（ATLL）36例，其中急性型20例，淋巴瘤型16例。在35例（66%）患者中获得治疗反应，包括17例（32%）完全反应。中位总生存期（OS）和无进展生存期（PFS）时间分别为14.3个月和5.2个月。与PTCL相比，ATLL患者显示出获得低缓解率（61% vs. 77%，P = 0.27）的趋势，OS（13.3 vs. 28.6个月，P = 0.04）和PFS（4.6 vs. 8.1个月，P = 0.01）显著较差。72%、34%和58%的患者分别发生3 - 4级中性粒细胞减少、贫血和血小板减少。在51%的患者中观察到发热性中性粒细胞减少，在2-9%的患者中观察到3级非血液学毒性。结论：THP-COP作为T细胞淋巴瘤的一线治疗方案，其疗效与CHOP相当。
Objective: The efficacy of pirarubicin (THP)-COP was previously compared with cyclophophamide + doxorubicin + vincristine + prednisolone (CHOP) in elderly patients with lymphoma. The subset analysis showed that T-cell lymphoma had a significantly better response with THP-COP, whereas no such difference was observed in B-cell lymphoma. The aim of this study is to confirm the efficacy of THP-COP in the treatment of T-cell lymphoma. Methods: We underwent a multicenter phase II study of THP-COP as a first-line treatment for T-cell lymphoma. The overall response rate, survival period, and toxicity were analyzed. Results: Fifty-three patients were enrolled in this study. Seventeen patients had peripheral T-cell lymphoma (PTCL), including nine of PTCL not otherwise specified (PTCL-NOS) and eight of angioimmunoblastic T-cell lymphoma (AITL). Thirty-six patients had adult T-cell leukemia/lymphoma (ATLL), including 20 of acute type and 16 of lymphoma type. A treatment response was obtained in 35 (66%) patients, including 17 (32%) complete responses. Median overall survival (OS) and progression-free survival (PFS) times were 14.3 months and 5.2 months, respectively. Patients with ATLL showed a tendency to obtain low response rate (61% vs. 77%, P = 0.27) and had a significantly inferior OS (13.3 vs. 28.6 months, P = 0.04) and PFS (4.6 vs. 8.1 months, P = 0.01) in comparison with PTCL. Grade 3 to 4 neutropenia, anemia, and thrombocytopenia occurred in 72%, 34%, and 58% of the patients, respectively. Febrile neutropenia was observed in 51% and grade 3 non-hematological toxicities in 2-9% of the patients. Conclusion: The efficacy of THP-COP is equivalent to that of CHOP for the first-line therapy in T-cell lymphoma.