利妥昔单抗联合CHOP方案治疗弥漫大B细胞性淋巴瘤的多中心临床研究(英文)

目的 :观察利妥昔单抗联合环磷酰胺、长春新碱、多柔比星及泼尼松 (CHOP方案 )治疗新诊断的弥漫性大B细胞性淋巴瘤 (DLBL)的临床疗效。　方法 :2 0 0 2年 4月至 2 0 0 3年 2月 ,共 5 2例病人进入本研究。化疗采用标准的CHOP方案 :d 1,环磷酰胺 6 0 0mg·m- 2 ,长春新碱 1.4mg·m- 2 ,多柔比星 2 5mg·m- 2 ,泼尼松 6 0mg·m- 2 × 5d ,每 3wk一个疗程 ,共 6个疗程。利妥昔单抗静脉滴注剂量为 375mg·m- 2 ,于化疗第一个疗程前 2d开始 ,每周输注 1次 (连续输注 ) ,连续 4次 (标准剂量 )或 6次 (增强剂量 ) ;或于每疗程的CHOP方案化疗前 2d输注 ,每 3周 1次 (间隔输注 ) ,输注 4次 (标准剂量 )或 6次 (增强剂量 )。结果 :5 0例病人进入临床疗效评估 ,6 0 %获得完全缓解 ,总有效率为 10 0 %。其中 ,34例AnnArbor分期为Ⅲ期或Ⅳ期的病人有15例获得完全缓解 ,完全缓解率为 4 4%。 5 0例病人共随访了 (8±s 5 )wk ,2～ 30wk ,病人 16wk的无病生存 (PFS)率为 87%。标准剂量组和增强剂量组疗效无显著差异 ,连续输注和间隔输注疗效差异亦无显著意义 (P >0 .0 5 )。所有病人在治疗过程中对本方案均能较好耐受 ,主要的不良反应为输注相关的不良反应 (32 % )和化疗相关的血液学不良反应 (2 0 % )。　结论 :利妥昔单?     

利妥昔单抗联合CHOP方案治疗NHL的临床疗效评价

目的:探讨利妥昔单抗联合环磷酰胺、阿霉素、长春新碱、强的松(CHOP)方案治疗非霍奇金淋巴瘤(NHL)的疗效及安全性。方法:62例NHL患者,其中32例接受利妥昔单抗联合CHOP方案治疗者为治疗组;30例接受CHOP方案治疗者为对照组。每周期21d,共进行6个疗程。结果:治疗组与对照组总有效率分别为75.00%、60.00%(P<0.05);2组毒副作用基本相似(P>0.05);治疗组的生活质量改善情况明显高于对照组(P<0.05)。结论:利妥昔单抗联合CHOP方案对NHL患者有较好疗效,且化疗药物的毒副作用未见增加。     

利妥昔单抗联合 CHOP为主方案治疗CD20+小儿 B细胞非霍奇金淋巴瘤的疗效及安全性

目的 观察利妥昔单抗治疗CD20+小儿B细胞非霍奇金淋巴瘤的疗效和毒性反应.方法 5例均为住院患者,用药剂量:375 mg/(m2·次),每周1次,连续 4次.可与化疗方案联用.结果 5例为完全缓解,其中Ⅲ期2例,Ⅳ期3例(白血病期1例).主要不良反应:低热2例,消化道反应、头晕 1例,关节疼痛、皮疹等,均未出现骨髓抑制.心、肝、肾功能均未见明显异常改变.结论 利妥昔单抗联合CHOP为主方案化疗是治疗CD20+小儿B细胞非霍奇金淋巴瘤有效而安全的方案.     

利妥昔单抗联合调整剂量EPOCH方案治疗老年中高危B细胞非霍奇金淋巴瘤临床分析

目的 探讨利妥昔单抗联合调整剂量EPOCH方案治疗老年中高危B细胞淋巴瘤患者的临床疗效及安全性。方法 纳入2008—2013年我院收治的老年中高危B细胞非霍奇金淋巴瘤共20例。治疗组8例,接受利妥昔单抗联合调整剂量EPOCH方案化疗（美罗华375mg/m^2 d0,长春新碱0.4mg/m^2＋表柔比星15mg/m^2＋依托泊苷50mg/m^2持续静滴24h d1~4,地塞米松15mg静滴d1~5,环磷酰胺750mg/m^2静滴d5）。对照组12例,接受利妥昔单抗联合CEOP方案化疗（美罗华375mg/m^2 d0,环磷酰胺750mg/m^2 d1,长春地辛4 mg d1,表柔比星60~80 mg/m^2 d1,地塞米松10~15 mg d1~5）。每21~28天为一个疗程。4个疗程后复查全身增强CT或PET-CT以评价治疗效果。结果 治疗组与对照组完全缓解率均为50%,总有效率相近（75%vs 83.3%）,治疗组III度以上的不良反应率均低于对照组,尤其是重症感染的发生率明显降低（0%vs 16.9%,P=0.027）。两组均无1例因化疗副作用终止治疗或死亡。结论 利妥昔单抗联合调整剂量EPOCH方案治疗老年中高危B细胞非霍奇金淋巴瘤,具有较好疗效,可显著降低化疗不良反应率,有助于提高总生存期。     

利妥昔单抗联合CHOP治疗B细胞性非霍奇金淋巴瘤的治疗体会

目的 探讨利妥昔单抗联合CHOP治疗B细胞性非霍奇金淋巴瘤的临床疗效.方法 2009年04月至2012年04月期间,我院诊治的60例B细胞性非霍奇金淋巴瘤患者,给予利妥昔单抗联合CHOP方案(环磷酰胺CTX、长春新碱VCR、表阿霉素EPI、强泼尼松PDN)进行治疗,对其临床疗效和不良反应等情况,进行观察.结果 60例B细胞性非霍奇金淋巴瘤患者,经过利妥昔单抗联合CHOP治疗后,有32例完全缓解(53.33%),24例部分缓解(40.00%),3例患者病情稳定(5.0%),有1例患者病情进展(1.67%),治疗的总有效率为93.33%.其中,8例患者出现脱发、恶心、呕吐、骨髓抑制等不良反应.结论 对于B细胞性非霍奇金淋巴瘤患者,利妥昔单抗联合CHOP治疗的疗效显著,并且不良反应少,值得临床广泛推广.     

利妥昔单抗联合CHOP为主方案治疗CD_(20)+小儿B细胞非霍奇金淋巴瘤疗效及安全性

目的观察利妥昔单抗治疗CD20+小儿B细胞非霍奇金淋巴瘤的疗效和毒性反应。方法5例均为住院患者,用药剂量:375mg/(m2.次),每周1次,连续4次。可与化疗方案联用。结果5例为完全缓解,其中Ⅲ期2例,Ⅳ期3例(白血病期1例)。主要不良反应:低热2例,消化道反应、头晕1例,关节疼痛、皮疹等,均未出现骨髓抑制。心、肝、肾功能均未见明显异常改变。结论利妥昔单抗联合CHOP为主方案化疗是治疗CD20+小儿B细胞非霍奇金淋巴瘤有效而安全的方案。     

美罗华治疗B细胞性非霍奇金淋巴瘤临床观察

目的观察利妥昔单抗（美罗华）联合CHOP方案治疗非霍奇金淋巴瘤的疗效及毒副反应。方法9例经病理组织学证实为CD20阳性的B细胞非霍奇金淋巴瘤患者接受利妥昔单抗375mg／m^2,静脉滴注,每3周1次。共4～6次。其间联用CHOP方案治疗4—6个疗程。结果9例患者治疗后,完全缓解6例,部分缓解2例,无变化1例,总有效率88．9％。所有患者均未见严重的不良反应。结论利妥昔单抗联合CHOP方案治疗B细胞非霍奇金淋巴瘤临床疗效较好,毒副反应较小。     

利妥昔单抗辅助化疗治疗淋巴瘤的临床应用及预后分析

目的研究利妥昔单抗辅助化疗治疗淋巴瘤的临床应用及预后分析。方法回顾性收集2017年4月至2018年2月本院住院治疗的淋巴癌患者109例为研究对象,分为对照组(n=52)和观察组(n=57),对照组采用CHOP方案(环磷酰胺+表柔比星+长春新碱+地塞米松);观察组采用CHOP方案联合利妥昔单抗治疗,比较两组的临床疗效的不良反应发生情况。结果治疗后,观察组患者的总有效率(89.47%)与对照组(55.77%)比较,观察组患者临床疗效优于对照组,两组患者差异具有统计学意义(P<0.05);治疗后,观察组不良反应发生率(17.54%)与对照组(40.38%)相比,差异无统计学意义(P>0.05)。结论在CHOP化疗方案的基础上给予利妥昔单抗治疗淋巴瘤,临床效果较单用CHOP方案效果显著,降低不良反应发生率。     

利妥昔单抗对于非霍奇金淋巴瘤的治疗及其药物经济学

目的:阐述利妥昔单抗对于非霍奇金淋巴瘤的疗效和药物的不良反应,并尝试探讨其药物经济学。方法:借鉴国外的研究并结合本院血液科对于这方面的探索,采用非传统的药物经济学模式来评价利妥昔单抗的治疗方案。结果:从药物经济学的角度而言,利妥昔单抗联合环磷酰胺 多柔比星(阿霉素) 长春新碱 泼尼松(CHOP)方案治疗非霍奇金淋巴瘤较传统单用CHOP方案优势明显。结论:利妥昔单抗具有较好的疗效和安全性,也是治疗非霍奇金淋巴瘤较经济的方法。     

利妥昔单抗联合CHOP方案的不良反应观察与护理

目的:探讨利妥昔单抗联合CHOP(环磷酰胺、阿霉素、长春新碱、强的松)方案应用时的不良反应和治疗护理对策.方法:对12例非霍奇金淋巴瘤(non-Hodgkin lymphoma,NHL)患者在使用利妥昔单抗联合CHOP方案22例次治疗中,记录其不良反应与处理过程.结果:12例患者输注前均存在对药物不良反应的恐惧和药物经济效价的怀疑等心理反应;3例出现严重的肝损害;1例出现多处淋巴结周围疼痛,经治疗护理后,患者心理反应消失,积极配合治疗.结论:有效的预防治疗和护理干预可减轻患者在用药中的不良反应.     

Aggressive lymphoma: improving treatment outcome with rituximab

The standard therapy for patients with aggressive lymphoma is cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) chemotherapy, which achieves a complete response in more than 60% of patients but is curative in only about 40-50%. More aggressive and/or dose-intensified chemotherapy regimens have failed to provide significant survival advantages compared with CHOP, and may have higher toxicity. Rituximab, a chimeric monoclonal antibody to the CD20 antigen, is effective as monotherapy in aggressive lymphoma and in combination with chemotherapy has demonstrated high response rates in phase II trials. A scheduled interim analysis of a randomized, prospective trial comparing rituximab plus CHOP with CHOP alone in elderly patients with untreated diffuse large B-cell lymphoma has shown significantly better response rates and survival with rituximab plus CHOP compared with CHOP alone. These results represent the first significant improvement in overall survival over CHOP in aggressive lymphoma for over 20 years. The addition of rituximab was not associated with significant additional toxicity over that seen with CHOP alone. Ongoing studies are underway to establish whether the survival benefit of rituximab plus CHOP is seen in younger patient populations. Rituximab in combination with chemotherapy is also being evaluated as salvage treatment for patients who relapse after initial chemotherapy. In a preliminary analysis of a study in 50 patients with refractory or relapsed aggressive lymphoma, rituximab plus etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (EPOCH) chemotherapy has demonstrated promising results when used as sole salvage therapy and as an induction therapy prior to autologous stem-cell transplantation, again without significant additional toxicity.     

Rituximab: new indication. In aggressive non Hodgkin lymphoma: benefits must be confirmed

The first-line treatment for diffuse large-B-cell non Hodgkin's lymphoma, a highly malignant lymphoma, is CHOP chemotherapy (cyclophosphamide + doxorubicin + vincristine + prednisone). Rituximab, a monoclonal antibody targeting certain B cells, has received a new indication in the treatment of this type of lymphoma, in combination with the CHOP protocol. In late 2002, the only available evaluation data came from one comparative, unblinded trial in patients over 60 years of age. Addition of rituximab to the CHOP protocol increased both the overall two-year survival rate (70% versus 57%), and the two-year event-free survival rate. Other trials are underway. In this trial, 9% of patients had major systemic reactions during the first rituximab infusion (respiratory disturbances, chills, fever and hypotension). These reactions did not occur during subsequent infusions. About 6% of patients had serious cardiac arrhythmias. In practice, the CHOP protocol remains the standard treatment for aggressive non Hodgkin's lymphoma. Pending further information, addition of rituximab to the CHOP protocol may be justified for patients who meet the inclusion criteria used in the only available clinical trial.     

Combination chemotherapy and rituximab

Rituximab is a human-mouse chimeric monoclonal antibody that has demonstrated efficacy against non-Hodgkin's lymphoma (NHL). There is a powerful rationale for combining rituximab treatment with chemotherapeutic agents that have also shown efficacy in NHL, since the mechanisms of action are distinct and there is also evidence that rituximab may sensitize chemoresistant tumor cells to the actions of cytotoxic drugs. A study of rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) chemoimmunotherapy has been carried out in 40 patients with low-grade NHL. In the 35 patients who completed the study, the overall response rate was 100%, with 63% achieving a complete response. Median time to progression has not yet been reached at 47.2+ months. Molecular analysis (polymerase chain reaction) showed that CHOP plus rituximab (unlike CHOP alone) could completely clear blood and bone marrow of cells containing the bcl-2 gene translocation, a molecular marker of NHL cells. Rituximab can therefore add to the efficacy of CHOP without significantly increasing toxicity. A further study is underway to determine whether similar efficacy with less overall toxicity can be achieved using rituximab in combination with fludarabine.     

R-CHOP和CHOP方案治疗早期原发性胃弥漫大B细胞淋巴瘤的疗效和毒性比较

目的探讨R-CHOP方案治疗早期原发性胃弥漫大B细胞淋巴瘤的临床疗效及不良反应。方法回顾性分析和比较采用R-CHOP方案（16例）以及CHOP方案（16例）治疗的初治早期（Ⅰ～Ⅱ期）胃弥漫大B细胞淋巴瘤患者的近期疗效及不良反应。结果 R-CHOP组患者化疗后CR8例,PR6例,SD1例,PD1例,有效率为87.5%（14/16）;CHOP组患者化疗后CR6例,PR5例,SD2例,PD3例,有效率为68.7%（11/16）,R-CHOP组有效率高于CHOP组（P〈0.05）。两组的不良反应主要为骨髓抑制、感染、粘膜炎、胃肠道反应、发热、肝功能损害。神经毒性及过敏反应等,经对症治疗后都能较快缓解,两组的不良反应发生率差异无统计学意义。结论 R-CHOP方案治疗早期胃弥漫大B细胞淋巴瘤的临床疗效优于CHOP方案,不良反应无明显差异。     

Rituximab: a review of its use in non-Hodgkin's lymphoma and chronic lymphocytic leukaemia

Rituximab is an anti-CD20 monoclonal antibody that has demonstrated efficacy in patients with various lymphoid malignancies, including indolent and aggressive forms of B-cell non-Hodgkin's lymphoma (NHL) and B-cell chronic lymphocytic leukaemia (CLL). While the optimal use of the drug in many clinical settings has yet to be clarified, two pivotal trials have established rituximab as a viable treatment option in patients with relapsed or refractory indolent NHL, and as a standard first-line treatment option when combined with cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) chemotherapy in elderly patients with diffuse large B-cell lymphoma (the most common type of aggressive NHL). The former was a noncomparative trial in relapsed indolent NHL (follicular and small lymphocytic subtypes) with clinical responses achieved in about half of patients treated with rituximab 375 mg/m(2) intravenously once weekly for 4 weeks, which was similar to some of the most encouraging results reported with traditional chemotherapeutic agents. The latter was a randomised comparison of eight cycles of CHOP plus rituximab 375 mg/m(2) intravenously (one dose per cycle) versus CHOP alone in previously untreated elderly patients (60 to 80 years of age) with diffuse large B-cell lymphoma. In this pivotal trial, 2-year event-free and overall survival were significantly higher with rituximab plus CHOP, and there was no increase in clinically significant adverse effects compared with CHOP alone. Treatment with rituximab is generally well tolerated, particularly in terms of adverse haematological effects and serious or opportunistic infections relative to standard chemotherapy. Infusion-related reactions occur in the majority of patients treated with rituximab; these are usually mild to moderate flu-like symptoms that decrease in frequency with subsequent infusions. In approximately 10% of patients, however, severe infusion-related reactions develop (e.g. bronchospasm, hypotension). These reactions are usually reversible with appropriate interventions and supportive care but there have been rare reports of fatalities. CONCLUSIONS: Clinical trials with rituximab indicate that the drug has broad application to B-cell malignancies, although further clarification is needed to determine its optimal use in many of these clinical settings. Importantly, rituximab in combination with CHOP chemotherapy has emerged as a new treatment standard for previously untreated diffuse large B-cell lymphoma, at least in elderly patients. Compared with conventional chemotherapy, rituximab is associated with markedly reduced haematological events such as severe neutropenia, as well as associated infections. Rituximab may be particularly suitable for elderly patients or those with poor performance status, and its tolerability profile facilitates its use in combination with cytotoxic drugs. PHARMACODYNAMIC PROPERTIES: Rituximab is a mouse/human chimaeric IgG(1)-kappa monoclonal antibody that targets the CD20 antigen found on the surface of malignant and normal B lymphocytes. Although treatment with rituximab induces lymphopenia in most patients, typically lasting about 6 months, a full recovery of B lymphocytes in the peripheral blood is usually seen 9-12 months after therapy, as CD20 is not expressed on haematopoietic stem cells. CD20 is, however, expressed on >90% of B-cell non-Hodgkin's lymphomas (NHL) and to a lesser degree on B-cell chronic lymphocytic leukaemia (CLL) cells.Although not fully elucidated, the cytotoxic effects of rituximab on CD20-positive malignant B cells appears to involve complement-dependent cytotoxicity, complement-dependent cellular cytotoxicity, antibody-dependent cellular cytotoxicity and induction of apoptosis. In addition, in vitro data indicate that rituximab sensitises tumour cells to the effects of conventional chemotherapeutic drugs. PHARMACOKINETIC PROPERTIES: Serum rituximab concentrations increased in proportion to dose across a wide range of single- and multiple-dose intravenous regimens in patients with B-cell NHL. When administll NHL. When administered at a dose of 375 mg/m(2) once weekly for 4 weeks in a pivotal trial in patients with relapsed or refractory indolent B-cell NHL (follicular or small lymphocytic subtypes), peak serum concentrations essentially doubled from the first (239.1 mg/L) to the fourth (460.7 mg/L) infusion, while elimination half-life (t(1/2)) increased from 76.3 to 205.8 hours (3.2 to 8.6 days). The concomitant increase in serum rituximab concentrations and t(1/2) with each successive infusion may be due, at least in part, to the elimination of circulating CD20-positive B cells and reduction or saturation of CD20-binding sites after the initial infusions of rituximab. The pharmacokinetic properties of rituximab are also characterised by wide inter-individual variability, and serum drug concentrations that are correlated with clinical response. Although pharmacokinetic data are limited in patients with aggressive forms of NHL, such as diffuse large B-cell lymphoma, rituximab appears to have a similar pharmacokinetic profile in these patients to that in patients with indolent B-cell NHL. The pharmacokinetics of rituximab are also reported to be similar whether the drug is administered with or without cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) chemotherapy. THERAPEUTIC USE: A number of studies have demonstrated efficacy of intravenous rituximab in patients with various lymphoid malignancies of B-cell origin, including indolent (e.g. follicular lymphoma) and aggressive (e.g. diffuse large B-cell lymphoma) forms of NHL, and CLL, but the drug has not yet been approved for use in CLL, and approved indications in NHL vary between countries. In the US, for example, rituximab is available for the treatment of patients with low-grade or follicular, relapsed or refractory, CD20-positive B-cell NHL. In Europe, the drug has similar approval for relapsed or refractory follicular NHL as in the US, but has also been approved for use in combination with CHOP chemotherapy for the most common aggressive form of NHL (CD20-positive, diffuse large B-cell lymphoma). Rituximab was approved for these indications primarily on the basis of results from two pivotal trials. In Japan, rituximab has been approved for indolent B-cell NHL and mantle cell lymphoma (an aggressive form of B-cell NHL), primarily on the basis of results of a Japanese phase II trial. Indolent NHL: Results of several studies evaluating rituximab 375 mg/m(2) once weekly for 4 weeks in patients with indolent forms of B-cell NHL (primarily follicular and small lymphocytic lymphomas) showed objective response (OR) rates ranging from approximately 40-60% in those receiving the drug for relapsed or refractory indolent B-cell NHL, and slightly higher (50-70%) for those receiving rituximab as first-line therapy. In a pivotal trial in 166 patients with relapsed or refractory low-grade or follicular B-cell NHL, intent-to-treat (ITT) analysis showed an OR rate of 48%, and a projected median time to progression of 13 months.Encouraging data are also emerging on the use of rituximab in combination with chemotherapeutic agents (e.g. CHOP, fludarabine-containing regimens) or other drugs (e.g. interferon-alpha2a) in previously untreated patients with indolent forms of B-cell NHL (primarily follicular and small lymphocytic subtypes). Rates for OR were consistently around 95%, with the majority being complete responses (CRs). Follow-up data from a study in 40 patients with low-grade or follicular B-cell NHL treated with rituximab plus CHOP as first-line therapy showed that responses were durable with a progression-free survival and median duration of response >5 years.Bcl-2 gene rearrangement (t14;18) occurs in malignant cells in up to 85% of patients with follicular lymphoma, and minimal residual disease in peripheral blood and bone marrow can be monitored using polymerase chain reaction (PCR). In several studies assessing blood and/or bone marrow, rituximab has achieved molecular response (conversion from PCR-positive to PCR-negative bcl-2 status) in at least half of the patients. Aggressive NHL: Studies with rituximab as monotherapy in aggressive B-cell NHL, a potentially curable disorder, have generally been restricted to patients with relapsed or recurrent disease, since CHOP has traditionally been the standard first-line treatment regimen. However, promising results from phase II monotherapy studies prompted further clinical investigation of rituximab in conjunction with chemotherapy. Thus, most studies with rituximab in patients with aggressive forms of B-cell NHL have involved combination therapy, including a pivotal randomised trial comparing eight cycles of standard CHOP therapy plus rituximab 375 mg/m(2) (one dose per cycle) versus CHOP alone in 399 previously untreated elderly patients (60-80 years of age) with diffuse large B-cell lymphoma. Results of the pivotal trial showed a clear advantage for rituximab plus CHOP versus CHOP in terms of event-free survival (primary endpoint) at 2 years (57% vs 38%, p < 0.001). Overall survival at 2 years (70% vs 57%, p < 0.01) and CR rate (76% vs 63%, p < 0.01) were also higher with the rituximab-CHOP combination. Other, smaller trials with rituximab in combination with CHOP or other chemotherapeutic regimens, either as first-line therapy or for patients with relapsed or refractory aggressive B-cell NHL, have also shown promising results in terms of clinical response rates.CLL: In relatively small trials (n < 40) conducted primarily in patients with relapsed or refractory B-cell CLL, rituximab monotherapy (various regimens) achieved OR rates of 23-45%, with median duration of response ranging from approximately 3-10 months. (ABSTRACT TRUNCATED)     

Rituximab: a review of its use in non-Hodgkin's lymphoma and chronic lymphocytic leukaemia

Rituximab (MabThera, Rituxan) is an anti-CD20 monoclonal antibody that induces lysis and apoptosis of normal and malignant human B cells, and sensitises malignant B cells to the cytotoxic effect of chemotherapy. In phase III trials in patients with indolent or aggressive B-cell non-Hodgkin's lymphoma (NHL), intravenous rituximab in combination with chemotherapy was more effective as first- or second-line therapy than chemotherapy alone in providing tumour remission and patient survival. Likewise, in patients with chronic lymphocytic leukaemia (CLL), rituximab in combination with chemotherapy appeared more effective than chemotherapy alone as either first- or second-line treatment. In addition, rituximab maintenance therapy was shown to significantly prolong tumour remission and patient survival in patients with indolent B-cell NHL or CLL. The combination of rituximab with cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) was cost effective as first-line therapy for advanced-stage diffuse large B-cell NHL compared with CHOP alone. Rituximab, either alone or in combination with chemotherapy, was generally well tolerated in patients with NHL or CLL. Overall, rituximab in combination with chemotherapy, is a valuable option for first- and second-line therapy in patients with advanced-stage indolent or aggressive B-cell NHL, and possibly those with B-cell CLL, and is included in current treatment guidelines for these indications. The drug is also potentially useful as maintenance therapy in patients with indolent B-cell NHL or CLL.     

Treatment of AIDS Related Non-Hodgkin's Lymphoma with Combination Mitoguazone Dihydrochloride and Low Dose Chop Chemotherapy: Results of a Phase II study

PURPOSE: To evaluate the response and side effects of combination therapy with low dose CHOP chemotherapy and mitoguazone dihydrochloride in patients with non-Hodgkin's lymphoma associated with the acquired immunodeficiency syndrome (AIDS-NHL). METHODS: Eighteen patients newly diagnosed with intermediate or high-grade AIDS-NHL were treated with low dose CHOP as follows: day 1, cyclophosphamide 350 mg/m(2), intravenously (IV); doxorubicin 25mg/m(2) IV; vincristine 2mg IV; and prednisone 100mg given orally on days 1 through 5. In addition, mitoguazone dihydrochloride was given at a dose of 600 mg/m(2) IV on days 1 and 15 of each 28-day treatment cycle. RESULTS: Seventeen males and one female patient were accrued. Twelve patients had high-grade pathologies while the remainder had an intermediate grade pathology (diffuse large cell). The median CD4+ lymphocyte count was 98/dl (range 1-924). Three patients (17%) reported an AIDS-defining illness prior to lymphoma diagnosis. Of 14 evaluable patients, 6 (43%) achieved a complete remission and 5 (35%) a partial remission. The median failure free and overall survival times were 6.5 and 8.4 months, respectively. Major toxicity was hematologic with grade 3 or 4 neutropenia in 72%; two patients died of neutropenic sepsis. CONCLUSIONS: Mitoguazone in combination with low dose CHOP is a safe regimen, associated with a response rate of 79% (CR 43%, PR 36%, 95% CI=49-95%). These preliminary results suggest no major improvement in terms of response over use of CHOP without mitoguazone.     

环磷酰胺治疗狼疮肾炎的疗效及副作用评价

目的 探讨在使用糖皮质激素的基础上静脉应用环磷酰胺(CYC)治疗狼疮肾炎(LN)的疗效及安全性.方法 随机选择狼疮肾炎患者32例,随访24周.CYC每次剂量0.75 g·m-2体表面积(每次0.6～1.0 g),每月静滴一次或CYC每次剂量0.6 g,每2周静滴一次;同时均联合泼尼松1 mg·kg-1·d-1治疗,病情...