期刊文献+

FC与FCR方案治疗慢性淋巴细胞白血病的临床回顾性分析 被引量:10

Retrospective clinical analysis of fludarabine and cyclophosphamide with or without rituximab for the treatment of patients with chronic lymphocytic leukemia
下载PDF
导出
摘要 目的:比较FC(氟达拉滨和环磷酰胺)和FCR(氟达拉滨、环磷酰胺和利妥昔单抗)方案治疗慢性淋巴细胞白血病(CLL)的临床疗效和预后影响。方法:回顾性分析本院2002年12月至2012年1月应用FC或FCR方案治疗的58例CLL患者病例资料,比较两种方案的疗效和预后影响。结果:FC组31例,FCR组27例。FCR组完全缓解(CR)率和总反应率(ORR)均高于FC组(44.4%vs.19.4%,P=0.039;81.5%vs.51.6%,P=0.017)。疗程结束后,FCR组患者获得微小残留病(microscopice residual disease,MRD)阴性比例高于FC组(37.0%vs.12.9%,P=0.032)。FCR和FC组患者中高危遗传学亚组患者PFS较非高危遗传学亚组患者短(P值分别为0.011,0.027),OS时间无明显差别。结论:FCR方案是治疗CLL患者的更为有效的方案。 Objective:This study aimed to compare the clinical efficacy and prognosis between rituximab plus fludarabine and cyclophosphamide (FCR) and fludarabine and cyclophosphamide (FC) regimens for patients with chronic lymphocytic leukemia (CLL). Methods:The clinical data of 58 patients with CLL treated with FCR or FC regimens from December 2002 to January 2012 were analyzed retrospectively. Therapy efficacy and prognosis were compared between the two groups. Results:Among the 58 pa-tients, 27 (44.4%) experienced complete remission (CR) in the FCR group and 31 patients (19.4%) experienced CR in the FC group (P=0.039). The overall response rate (ORR) of the FCR group was higher than that of the FC group (81.5%and 51.6%, respectively, P=0.017). Fourteen patients achieved MRD-negative rating after therapy. PFS and OS in MRD-negative patients were superior compared with the MRD-positive group (P=0.000, 0.003). The proportion of MRD-negative patients in the FCR group was higher than that in the FC group (37.0%and 12.9%, respectively, P=0.032). PFS in high-risk genetic patients was lower than that in low-risk genetic patients (P=0.011, 0.027). The OS time between the two groups did not exhibit any difference. Conclusion:FCR produced a high CR and ORR in patients with CLL. Many patients in the FCR group were responsive to the treatment. Thus, FCR could be a more effective regimen than FC for patients with CLL.
出处 《中国肿瘤临床》 CAS CSCD 北大核心 2014年第9期566-570,共5页 Chinese Journal of Clinical Oncology
基金 国家自然科学基金项目(编号:81370632,81200395)资助~~
关键词 慢性淋巴细胞白血病 利妥昔单抗 氟达拉滨 环磷酰胺 抗肿瘤联合化疗方案 B cell chronic lymphocytic leukemia rituximab fludarabine cyclophosphamide antineoplastic combined chemother-apy protocol
  • 相关文献

参考文献15

  • 1Lin TS. What is the optimal initial treatment for chronic lymphocyt- ic leukemia[J]? Oncology (W'illiston Park), 2007, 21 (14):1641-1649.
  • 2Hallek M,Cheson BD, Catovsky D,et al. Guidelines for the diagno- sis and treatment of chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute-Working Group 1996 guidelines[J]. Blood, 2008, 111 (12):5446-5456.
  • 3Guo B,Zhu HL, Fan H, et al. Individualized fludarabine-based regi- men in elderly patients with chronic lymphocytic leukemia/small lymphocytic lymphoma[J]. Adv Ther, 2012, 29(2):178-186.
  • 4Flinn IW, Neuberg DS, Grever MR, et al. Phase : trial of fludara- bine plus cyclophosphamide compared with fludarabine for patients with previously untreated chronic lymphocytic leukemia: US Inter- group Trial E299[J].J Clin Oncol, 2007, 25(7):793-798.
  • 5Keating MJ, O'Brien S, Albitar M, et al. Early results of a chemoim- munotherapy regimen of fludarabine, cyclophosphamide, and ritux- imab as initial therapy for chronic lymphocytic leukemia[J]. J Clin Oncol, 2005, 23(18):4079-4088.
  • 6James DF, Kipps TJ. Rituximab in chronic lymphocytic leukemia[J]. Adv Ther, 2011, 28(7):534-554.
  • 7Hillmen P. Using the biology of chronic lymphocytic leukemia to choose treatment[J]. Hematology Am Soc Hematol Educ Program, 2011, 2011:104-109.
  • 8HaUek M, Fischer K, Fingerle-Rowson G, et al. Addition of ritux- imab to fludarablne and cyclophosphamide in patients with chronic lymphocytic leukaemia: a randomised, open-label,phase 3 trial[J]. Lancet, 2010, 376(9747):1164-1174.
  • 9Veliz M, Pinilla-lbarzJ. Treatment of relapsed or refractory chron- ic lymphocytic leukemia[J]. Cancer Control, 2012, 19(1):37-53.
  • 10Robak T, Dmoszynska A, SolaJ-C61igny P, et al. Rituximab plus fludarabine and cyclophosphamide prolongs progression-free sur- vival compared with fludarabine and cyclophosphamide alone in previously treated chronic lymphocytic leukemia[J]. J Clin Oncol,2010, 28(10):1756-1765.

二级参考文献15

  • 1Hallek M,Cheson BD,Catovsky D,et al.Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia:a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute-Working Group 1996 guidelines.Blood,2008,111:5446-5456.
  • 2Xu W,Li JY,Wu YJ,et al.CD38 as a prognostic factor in Chinese patients with chronic lymphocytic leukaemia.Leuk Res,2009,33:237-243.
  • 3Chen L,Zhang Y,Zheng W,et al.Distinctive IgVH gene segments usage and mutation status in Chinese patients with chronic lymphocytic leukemia.Leuk Res,2008,32:1491-1498.
  • 4Rozman C,Montserrat E.Chronic lymphocytic leukemia.N Engl J Med,1995,333:1052-1057.
  • 5Catovsky D,Richards S,Matutes E,et al.Assessment of fludarabine plus cyclophosphamide for patients with chronic lymphocytic leukaemia (the LRF CLL4 Trial):a randomised controlled trial.Lancet,2007,370:230-239.
  • 6Rai KR,Peterson BL,Appelbaum FR,et al.Fludarabine compared with chlorambucil as primary therapy for chronic lymphocytic leukemia.N Engl J Med,2000,343:1750-1757.
  • 7Yamauchi T,Nowak BJ,Keating MJ,et al.DNA repair initiated in chronic lymphocytic leukemia lymphocytes by 4-hydroperoxycyclophosphamide is inhibited by fludarabine and clofarabine.Clin Cancer Res,2001,7:3580-3589.
  • 8Eichhorst BF,Busch R,Hopfinger G,et al.Fludarabine plus cyclophosphamide versus fludarabine alone in flrst-line therapy of younger patients with chronic lymphocytic leukemia.Blood,2006,107:885-891.
  • 9Stolz C,Schuler M.Molecular mechanisms of resistance to Rituximab and pharmacologic strategies for its circumvention.Leuk Lymphoma,2009,50:873-885.
  • 10Di Gaetano N,Xiao Y,Erba E,et al.Synergism between fludarabine and rituximab revealed in a follicular lymphoma cell line resistant to the cytotoxic activity of either drug alone.Br J Haematol,2001,114:800-809.

共引文献15

同被引文献46

  • 1马军,王建祥,主编.造血系统疾病临床诊疗规范教程[M].北京:北京大学医学出版社,2009:548.
  • 2Hallek M, Cheson BD, Catovsky D, et al. Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer InstituteWorking Group 1996 guidelines [J]. Blood, 2008, 111(12): 5446-5456.
  • 3Pepper C, Lowe H, Fegan C, et al. Fludarabine-mediatedsuppression of the excision repair enzyme ERCC1 contributes to the cytotoxic synergy with the DNA minor groove crosslinking agent SJG-136 (NSC694501) in chronic lymphocytic leukaemia cells [J]. Br J Cancer, 2007, 97(2): 253-259.
  • 4Rai KR, Peterson BL, Appelbaum FR, et al. Fludarabine compared with chlorambucil as primary therapy for chronic lymphocytic leukemia [J]. N Engl J Med, 2000, 343(24): 1750-1757.
  • 5Rai K, Peterson B, Appelbaum F, et al. Long-term survival analysis of the North American Intergroup Study C9011 comparing fludarabine (F) and chlorambucil (C) in previously untreated patients with chronic lymphocytic leukemia (CLL) [ J/Abstract ]. Blood, 2009, 114(22): A-536.
  • 6Leporrier M, Chevret S, Cazin B, et al. Randomized com- parison of fludarabine, CAP and CHOP in 938 previously untreated stage B and C chronic lymphocytic leukemia patients [J]. Blood, 2001, 98(8): 2319-2325.
  • 7Flinn IW, Neuberg DS, Grever MR, et al. Phase Ⅲtrial of fludarabine plus cyclophosphamide compared with fludara- bine for patients with previously untreated chronic lymphocytic leukemia: US Intergroup Trial E2997 [J]. J Clin Oncol, 2007, 25(7): 793-798.
  • 8Thomas DA. Rituximab as therapy for acute lymphoblastic leukemia [J]. Clin Adv Hematol Oncol, 2010, 8(3): 168-171.
  • 9James DF, Kipps TJ. Rituximab in chronic lymphocytic leukemia [J]. Adv Ther,. 2011, 28(7): 534-554. d.
  • 10Keating MJ, O'Brien S, Albitar M, et al. Early re- suits of chemo-immunotherapy regimen of fludarabine cyclophosphamide,and rituximab as initial therapy for chronic lymphocytic leukemia [J]. J Clin Oncol, 2005, 23(18): 4079-4088.

引证文献10

二级引证文献27

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部