惰性淋巴瘤规范化相关治疗－08年NCCN相关治疗指南解读.ppt

Actuarial survival curves for patients with indolent NHL treated at Stanford University from 1960 to 1976, 1976 to 1987, and 1987 to 1996 are essentially indistinguishable, which shows that the widespread use of single-agent or multiagent chemotherapy or combined modality therapy has not had a significant impact on the natural course of the disease.54 Slide 41: Rituximab + Fludarabine/Cyclophosphamide/Mitoxantrone in Relapsed or Primary Refractory Follicular Lymphoma The German Low-Grade Lymphoma Study Group (GLSG) recently published preliminary results of their randomized controlled phase III study evaluated the efficacy and safety of the addition of rituximab to combination chemotherapy in follicular lymphoma. (Hiddemann et al, 2003; Dreyling et al, 2003) A total of 93 patients with follicular lymphoma have been enrolled in the study and efficacy data were published by Hiddemann, et al. for 49 of these patients. Study treatment consisted of FCN monotherapy or FCN plus rituximab. Those achieving a complete or partial response underwent further randomization to rituximab maintenance (2 treatment blocks of 4 infusions 3 and 9 months after remission), or to observation only. FCN regimen included: fludarabine 25 mg/m2 Days 1-3; cyclophosphamide 200 mg/m2 days 1-3; mitoxantrone 8 mg/m2 Day 1 every 28 days. FCN was generally salvage therapy as most patients had previously received CHOP first-line therapy. Rituximab (375 mg/m2 on Day 1) was given 1 day prior to the start of FCN chemotherapy. In the 49 patients with follicular data for whom efficacy data are available, the overall response rate was 92% in the rituximab plus FCN treatment group compared to 75% in the FCN group. The FCN plus rituximab treatment was well tolerated with no difference in adverse events (neither hematologic nor nonhematologic) observed compared to the FCN group. Longer follow-up data evaluating if a survival advantage was associated with the combination of rituximab plus FCN was recently p