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Blood:来那度胺联合利妥昔单抗作为套细胞淋巴瘤的初始治疗,缓解率高且持久

2018-09-06 MedSci MedSci原创

中心点:来那度胺联合利妥昔单抗作为MCL的诱导和维持疗法可获得持久的MRD阴性的完全缓解。长期治疗相关的不良事件通常是非累积性的,且仍可控。摘要:研究人员开展了一多中心的2期试验,招募了38位未治疗过的MCL患者,中位年龄65岁,套细胞淋巴瘤国际预后指数(MIPI)评分分布在低、中、高风险(分别占34%、34%和32%),予以来那度胺联合利妥昔单抗(LR)作为初始治疗,包括诱导和维持。治疗持续至病

中心点:

来那度胺联合利妥昔单抗作为MCL的诱导和维持疗法可获得持久的MRD阴性的完全缓解。

长期治疗相关的不良事件通常是非累积性的,且仍可控。

摘要:

研究人员开展了一多中心的2期试验,招募了38位未治疗过的MCL患者,中位年龄65岁,套细胞淋巴瘤国际预后指数(MIPI)评分分布在低、中、高风险(分别占34%、34%和32%),予以来那度胺联合利妥昔单抗(LR)作为初始治疗,包括诱导和维持。治疗持续至病情进展或3年后患者选择终止。

27位(75%)患者完成了至少3年的治疗研究。中位随访64个月(21-78)时,3年无进展存活率(PFS)和总体存活率(OS)分别是80%和90%,5年PFS和OS分别是64%和77%。

在维持期间,血液学AEs包括无症状的3-4级血细胞减少(中性粒细胞减少 42%、血小板减少 5%、贫血 3%),门诊患者多见1-2级感染(上呼吸道感染[URI]45%、泌尿道感染[UTI] 21%、鼻窦炎 13%、蜂窝织炎 11%和肺炎 8%)。非血液学AEs,如体质和炎症症状,发生频率和严重程度均低于诱导时的。

在10位完成至少3年治疗的患者中,有8位患者的外周血液MRD试验显示为MRD阴性CR。随着随访时间的延长,LR作为MCL的初始诱导和维持治疗,继续表现出持久的缓解和可管理的安全性。

原始出处:

Jia Ruan, Peter Martin, et al. Five-year follow-up of lenalidomide plus rituximab as initial treatment for mantle cell lymphoma. Blood  2018  :blood-2018-07-859769;  doi: https://doi.org/10.1182/blood-2018-07-859769

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    2018-10-10 想快快成长的医学小白

    学习了

    0

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    2018-09-06 ylzr123

    好文,值得点赞!认真学习,应用于实践!谢谢分享给广大同好!

    0

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套细胞淋巴瘤(MCL)是起源于淋巴结套区的一种罕见B细胞淋巴瘤亚型,以t(11;14)(q13; q32)染色体异常及Cyclin D1过表达为其独特的分子生物学特征。MCL多见于中老年人,临床病程多呈侵袭性,且预后差。目前,对于年轻MCL 患者治疗均推荐含大剂量阿糖胞苷(HD-Ara-c)的诱导方案联合自体造血干细胞移植(ASCT),而对于老年患者或不能进行 ASCT 的患者则推荐利妥昔单抗联合

Blood:SOX11可放大BCR信号,促进MCL样肿瘤细胞进展

中心点:B细胞特异性过表达SOX11可促进B1a B细胞致瘤性增殖,并驱动出现MCL样表型。SOX11过表达与通过BCR信号增强的信号通路相关,BCR信号可被药物BTK抑制剂逆转。摘要:套细胞(MCL)的特点是B细胞受体(BCR)信号增强,应用BTK抑制剂治疗MCL患者可获得积极的治疗效果。但对导致MCL发生BCL信号增强的潜在机制尚不明了,尤其是在其他的淋巴瘤中,BCR信号上游调控子(如CD79

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