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首页> 外文期刊>British Journal of Haematology >Rituximab, used alone or in combination, is superior to other treatment modalities in splenic marginal zone lymphoma
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Rituximab, used alone or in combination, is superior to other treatment modalities in splenic marginal zone lymphoma

机译：利妥昔单抗单独或联合使用优于脾边缘区淋巴瘤的其他治疗方式

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摘要

Splenic marginal zone lymphoma (SMZL) is a rare B-cell malignancy, with no standard treatment other than splenectomy. Rituximab has shown encouraging results. We therefore retrospectively assessed 43 patients from two centres, who received rituximab, either alone or with chemotherapy. All patients responded, 34/43 (79%) achieving a complete response (CR), compared with 3/10 (30%) after chemotherapy without rituximab (P = 0·005). Of these 10 patients, 9 (90%) subsequently achieved a CR after rituximab (P = 0·02). Rituximab monotherapy appeared equally as effective as rituximab combination therapy (90% vs. 79% CR, P = 0·7) with significantly less toxicity (12·5% vs. 83%, P = 0·002). Splenectomized patients were more likely to obtain a CR with rituximab (16/16, 100%) than unsplenectomized patients (18/27, 67%, P = 0·008). Disease-free survival (DFS) at 3 years was better after rituximab than after splenectomy alone [79% (95% confidence interval 60-89) vs. 29% (8-54), Hazard ratio (HR) 0·28 (0·12-0·68), P = 0·003] and better than after chemotherapy without rituximab [25% (4-55), HR 0·21 (0·08-0·51), P = 0·0004]. Survival at 3 years after rituximab was 98%. In summary, the CR and DFS rates after rituximab, given alone or with chemotherapy, were significantly better than after chemotherapy without rituximab in the same patients, with manageable toxicity. Rituximab, with or without splenectomy, should be considered for the treatment of SMZL.
机译：脾边缘区淋巴瘤（SMZL）是一种罕见的B细胞恶性肿瘤，除脾切除术外没有其他标准治疗方法。利妥昔单抗已显示令人鼓舞的结果。因此，我们回顾性评估了来自两个中心的43名接受利妥昔单抗治疗的患者，这些患者单独或联合接受化疗。所有患者有反应，有34/43（79％）达到完全缓解（CR），而无利妥昔单抗的化疗后为3/10（30％）（P = 0·005）。在这10例患者中，有9例（90％）随后在利妥昔单抗治疗后获得了CR（P = 0·02）。利妥昔单抗单药治疗的效果与利妥昔单抗联合治疗等效（90％vs. 79％CR，P = 0·7），毒性显着降低（12·5％vs. 83％，P = 0·002）。脾切除的患者比未切除脾的患者（18 / 27，67％，P = 0·008）更有可能接受利妥昔单抗治疗（16 / 16，100％）。利妥昔单抗治疗3年后的无病生存率（DFS）优于单纯脾切除术后[79％（95％置信区间60-89）对29％（8-54），危险比（HR）0·28（0 ·12-0·68），P = 0·003]，比不使用利妥昔单抗的化疗后更好[25％（4-55），HR 0·21（0·08-0·51），P = 0·0004] 。利妥昔单抗治疗3年后的生存率为98％。总之，在具有可控毒性的同一患者中，单独或联合使用利妥昔单抗后的CR和DFS率显着优于不使用利妥昔单抗的化疗后。利妥昔单抗，伴或不伴脾切除术，应考虑用于SMZL的治疗。

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