Rituximab affects the prognosis of patients with nonHodgkin's lymphomas

Barbara Jezeršek Novaković (Author), Marjeta Vovk (Author), Simona Borštnar (Author), Radka Tomšič (Author)

Abstract

Backround. Rituximab - the most widely used monoclonal antibody in the B cell lymphoid malignancies has been applied successfully in the treatment of relapsed and refractory indolent CD20 positive B cell lymphomas and more recently, also in the treatment of aggressive lymphomas in combination with standard chemotherapy. Albeit the chemo-immunotherapy has a wide range of potential applications, there are still several issues that have to be resolved: (1) the optimal scheduling of antibody-chemotherapy combinations, (2) the most active of these combinations, as well as (3) the predictors of response to rituximab. Patients and methods. To facilitate addressing the first two questions, we performed an analysis in 25 patients with different histological types of CD20 positive nonHodgkin's lymphomas (10 aggressive and 15 indolent). Seventeen patients were treated with chemo-immunotherapy for a relapse, and just in 8 patients rituximab was added to first line chemotherapy. Most of the responders received the CHOP regimen, but also otherregimens (FC, BVCPP) were effective in combination with rituximab. Results. The overall response rate was 76%, with 68% complete remissions. The median response duration has not been reached yet. The response was markedly better in the group of previously untreated patients, where the overall response rate reached 100%, with 7 patients in complete and 1 patient in partial remission. Most of the treatment failures occurred in heavily pretreated patients with aggressive lymphomas. No serious adverse effects wereobserved. Conclusion The chemo-immunotherapy improves the treatment outcomes in patients with untreated and relapsed CD20 positive nonHodgkin's lymphomas in comparison to chemotherapy alone. The combined treatment is the most effective when used as soon as possible (preferably as the first line treatment). (Abstract truncated at 2000 characters).

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Data

Language:	English
Year of publishing:	2004
Typology:	1.01 - Original Scientific Article
Organization:	OI - Institute of Oncology
Publisher:	Association of Radiology and Oncology
UDC:	616-097
COBISS:	17662681
ISSN:	1318-2099
Views:	48
Downloads:	14
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Secondary language:	Slovenian
Secondary title:	[Rituximab spreminja prognozo bolnikov z neHodgkinovimi limfomi]
Secondary abstract:	Izhodišča. Rituximab - najpogosteje uporabljeno monoklonalno protitelo s področja B celičnih limfoproliferativnih obolenj - se je izkazal kot uspešno zdravilo pri zdravljenju ponovitev ali refraktarnih oblik indolentnih CD20 pozitivnih B celičnih limfomov, v novejšem času pa tudi pri zdravljenju agresivnih limfomov v kombinaciji s standardno citostatsko terapijo. Čeprav ima takšna kemo-imunoterapija širok razpon indikacij, ostajajo v zvezi z njo številna vprašanja, ki jih je potrebno razjasniti: (1) kakšno je optimalno časovno zaporedje aplikacij protiteles in citostatikov in kateri odmerki omenjenih substanc so najbolj učinkoviti, (2) kateri citostatiki so najbolj učinkoviti v kombinaciji z rituximabom, ter nenazadnje, (3) kateri so napovedni dejavniki, ki napovedujejo ugoden odziv na rituximab. Bolniki in metode. Z namenom delno razjasniti prvi dve vprašanji, smo opravili analizo rezultatov zdravljenja s kemo-imunoterapijo pri 25 bolnikih z različnimi histološkimi podtipi CD20 pozitivnih B celičnih limfomov (10 agresivnih in 15 indolentnih). Sedemnajst bolnikov je prejemalo kemo-imunoterapijo za zdravljenje ponovitev limfoma in le pri 8 bolnikih smo rituximab dodali k citostatski terapiji prvega reda. Večina bolnikov, ki se je ugodno odzvala na zdravljenje, je v koritbinaciji z rituximabom prejemala shemo CHOP, kot uspešne pa so se izkazale tudi druge kombinacije citostatikov (FC, BVCPP). Rezultati. V celoti smo odgovor na kemo-imunoterapijo dosegli pri 76% bolnikov, pri 68% smo ugotovili popolni odgovor. Srednjega trajanja odgovora še nismo dosegli. Odgovor na terapijo je bil precej boljši v skupini bolnikov,ki pred tem še ni bila zdravljena, saj smo v tej skupini odgovor na terapijo dosegli pri vseh (100%) bolnikih in sicer popolni odgovor pri 7 in delni odgovor pri 1 bolniku. Kemo-imunoterapija pa je bila neuspešna prvenstveno pri bolnikih z agresivnimi limfomi, ki so bili pred tem že večkratzdravljeni. (Izvleček skrajšan pri 2000 znakih).
Secondary keywords:	Lymphoma, Non-Hodgkin'S;Drug Therapy;Antibodies, Monoclonal;Therapeutic Use;Antigens, Cd20;Treatment Outcome;Protitelesa monoklonska;Antigeni, CD20;Zdravljenje, izid;
Source comment:	BSDOCID105370;
Pages:	str. 15-19
Volume:	ǂLetn. ǂ38
Issue:	ǂšt. ǂ1
Chronology:	2004
ID:	22859839