濾胞性リンパ腫に対するリツキシマブ併用化学療法の当科における成績 (医学部血液内科学教室 泉二登志子教授退任記念特別号)  [in Japanese] Outcome of Rituximab-combined Chemotherapy for Follicular Lymphoma : A Single-center Study  [in Japanese]

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Abstract

濾胞性リンパ腫は低悪性度B細胞リンパ腫として位置づけられる疾患である. 抗CD20抗体であるリツキシマブを併用した化学療法により予後は改善されたが,依然治癒が困難なリンパ腫である. 2002年1月から2012年6月までの当科でリツキシマブ併用化学療法が施行された濾胞性リンパ腫61例について後ろ向き解析を行った.年齢中央値は61才(41-85才). WHO分類によるGrade 1/2は44例で, Grade 3は17例であった. 初期治療としてR-CHOP(リツキシマブ, エンドキサン, ドキソルビシン, ビンクリスチン, プレドニゾロン)療法が61例中55例で, リツキシマブの維持療法が59例中28例で施行されていた. 全例での初期治療後の完全寛解は80%で, 部分寛解は11%で, 5年での全生存は90.8%, 無再発生存は60.5%あった. Grade 1/2 の44例において, 国際予後指標(FLIPI 1)の予後の予測に対する有用性は低かった. 予後に影響を与える因子として,多変量解析で, 無再発生存および全生存に対して, リツキシマブによる維持療法が予後因子であった.

Follicular lymphoma is an indolent type of B-cell lymphoma. Although combination chemotherapy with the anti-CD20 antibody rituximab has improved patient outcome, there exists a consensus that some histological subtypes are incurable, for which standard treatment is not yet established. Here, we retrospectively analyzed 61 patients with follicular lymphoma who received rituximab-combined chemotherapy as first-line treatment in our institute between January 2002 and June 2012. The median age of the patients was 61 years (range, 41 to 85 years). According to the World Health Organization classification, 44 patients were classified as having grade 1 or 2 disease, and 17 as having grade 3 disease. Of the 61 patients, 55 received R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) as induction therapy, and 28 patients subsequently received rituximab as maintenance therapy. The complete and partial remission rate was 80% and 11%, respectively. The rate of overall survival and relapse-free survival at 5 years was 90.8% and 60.5%, respectively. The Follicular Lymphoma International Prognosis Index did not accurately predict survival in patients with grade 1 or 2 follicular lymphoma. In multivariate analysis, rituximab maintenance therapy was a prognostic factor for relapse-free and overall survival.

Journal

  • Journal of Tokyo Women's Medical College

    Journal of Tokyo Women's Medical College 83(臨増), E563-568, 2013-03

    Tokyo Women's Medical University

Codes

  • NII Article ID (NAID)
    110009575066
  • NII NACSIS-CAT ID (NCID)
    AN00161368
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • Journal Type
    大学紀要
  • ISSN
    0040-9022
  • NDL Article ID
    024731141
  • NDL Call No.
    Z19-400
  • Data Source
    NDL  NII-ELS  IR 
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