Addition of lenalidomide to rituximab, ifosfamide, carboplatin, etoposide (RICER) in first-relapse/primary refractory diffuse large B-cell lymphoma.
Addition of lenalidomide to rituximab, ifosfamide, carboplatin, etoposide (RICER) in first-relapse/primary refractory diffuse large B-cell lymphoma.
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DOI：
10.1111/bjh.12846
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发表时间：
2014-07
影响因子：
6.5
通讯作者：
Goy A
中科院分区：
文献类型：
--
作者：
Feldman T;Mato AR;Chow KF;Protomastro EA;Yannotti KM;Bhattacharyya P;Yang X;Donato ML;Rowley SD;Carini C;Valentinetti M;Smith J;Gadaleta G;Bejot C;Stives S;Timberg M;Kdiry S;Pecora AL;Beaven AW;Goy A
复发/难治性弥漫性大B细胞淋巴瘤(DLBCL)预后较差。免疫化疗失败或在诱导后12个月内复发后，结果尤其糟糕。我们进行了来那度胺联合大米(利妥昔单抗、异环磷酰胺、卡铂和依托泊苷)(RICER)的I/II期试验，作为首次复发或原发难治性DLBCL的抢救方案。来那度胺与大米联合用药，每14d一次，化疗敏感性疾病患者经过3个周期的化疗后，用BEAM[卡莫司汀、依托泊苷、阿糖胞苷、马法兰]采集并巩固干细胞，然后进行自体干细胞移植(AutoSCT)。90天内自体干细胞移植毒性恢复的患者开始接受来那度胺每天25 mg，每28天21次的维持治疗，持续12个月。来那度胺25 mg加大米没有发生剂量限制或意外毒性。3/4级血液学毒性得到适当解决，并保留了RICER的计划剂量密度和剂量强度。在三个周期中的任何一个周期中都不需要减少来那度胺或赖斯的剂量。经过两个周期的RICER治疗，15名患者中有9名(60%)完全缓解，2名患者(13%)部分缓解。来那度胺与莱斯联合应用是可行的，并在高危DLBCL患者中产生有希望的应答率(特别是完全应答率)。
Relapsed/refractory diffuse large B-cell lymphoma (DLBCL) is associated with a poor prognosis. Outcomes are particularly poor following immunochemotherapy failure or relapse within 12 months of induction. We conducted a Phase I/II trial of lenalidomide plus RICE (rituximab, ifosfamide, carboplatin, and etoposide) (RICER) as a salvage regimen for first-relapse or primary refractory DLBCL. Dose-escalated lenalidomide was combined with RICE every 14 d. After three cycles of RICER, patients with chemosensitive disease underwent stem cell collection and consolidation with BEAM [BCNU (carmustine), etoposide, cytarabine, melphalan] followed by autologous stem cell transplantation (autoSCT). Patients who recovered from autoSCT toxicities within 90 d initiated maintenance treatment with lenalidomide 25 mg daily for 21 d every 28 d for 12 months. No dose-limiting or unexpected toxicities occurred with lenalidomide 25 mg plus RICE. Grade 3/4 haematological toxicities resolved appropriately, and planned dose density and dose intensity of RICER were preserved. No lenalidomide or RICE dose reductions were required in any of the three cycles. After two cycles of RICER, nine of 15 patients (60%) achieved a complete response, and two achieved a partial response (13%). Combining lenalidomide with RICE is feasible, and results in promising response rates (particularly complete response rates) in high-risk DLBCL patients.
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影响因子：
10.1
作者：
Chiappella, Annalisa;Tucci, Alessandra;Vitolo, Umberto
通讯作者：
Vitolo, Umberto
DOI：
10.1182/asheducation-2012.1.410
发表时间：
2012-12-01
期刊：
HEMATOLOGY-AMERICAN SOCIETY HEMATOLOGY EDUCATION PROGRAM
影响因子：
--
作者：
Gisselbrecht, Christian
通讯作者：
Gisselbrecht, Christian
影响因子：
2.7
作者：
Zinzani, Pier Luigi;Pellegrini, Cinzia;Baccarani, Michele
通讯作者：
Baccarani, Michele
影响因子：
20.3
作者：
Kewalramani, T;Zelenetz, AD;Moskowitz, CH
通讯作者：
Moskowitz, CH
影响因子：
51.1
作者：
Wang, Michael;Fayad, Luis;Romaguera, Jorge
通讯作者：
Romaguera, Jorge