移植组rchop×1+asctn=125.ppt

在2012年欧洲ESMO指南中对于DLBCL一线治疗的推荐中，美罗华联合化疗的推荐疗程均为6至8疗程。 * Javeed Iqbal1 et al. Clin Cancer Res; 17(24); 7785–95. ABC-DLBCL GCB-DLBCL 主要内容 诱导治疗 — 一线治疗目的: 以治愈为目标 — 标准治疗 vs 精准治疗:预后分层治疗 巩固强化治疗 — 造血干移植（自体）的地位 CLL及FL治疗进展 靶向治疗进展 A new anti-lymphoma combination: LBR 3+3 design with 10 additional subjects at the MTD Lenalidomide - BR untreated CLL Bendamustine-Rituximab Bendamustine 90mg/m2 days 1-2 of 28 day cycle; Rituximab 375mg/m2 on day 1 of cycle 1, then 500mg/m2 on day 1 of cycles 2-6 Lenalidomide: 3 dose levels planned Lenalidomide 2.5mg daily days 8-21 (cycle 1 only), then 2.5mg daily days 1-21 (cycles 2-6) Lenalidomide 2.5mg daily days 8-21 (cycle 1 only), then 5mg daily days 1-21 (cycles 2-6) Lenalidomide 5mg daily days 8-21 (cycle 1 only), then10mg daily days 1-21 (cycles 2-6) Supportive care with allopurinol (through day 14 cycle 2), pegfilgrastim, aspirin (or other anticoagulant), acyclovir and Bactrim (or equivalent). Clinical adverse events Any events in ≥ 10% of subjects, and grade 3-4 in 1 subject * Includes one case each of CMV reactivation, disseminated Zoster, and thrush Percentage (%) Grade 1-2 (%) Grade 3-4 (%) Response OR CR + CRi PR PD NE All Patients (n=23) 20 (87%) [95% CI 66%-97%] 9 (39%) 11 (48%) 0 3 (13%) MTD only (n=13) 12 (92%) [95% CI 64%-100%] 4 (31%) 8 (62%) 0 1 (8%) Response Summary and Conclusions Lenalidomide added to BR results in high efficacy in previously untreated CLL Notable toxicities were rash, neutropenia despite pegfilgrastim support, and pulmonary embolism despite aspirin. No DLTs were observed at the target dose level of 10mg lenalidomide, but dose reductions in later cycles were common due to accruing toxicity. LBR LBR LBR LBR LBR LBR L L L L L L L 1 5 9 13 17 21 25 29 33 37 41 45 49 Weeks CT CT, PET MRD CT, PET MRD Lenalidomide-Rituximab-Bendamustine in first line for patients 65 with mantle cell l