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Lancet oncol：R-CHOP联合甲氨蝶呤和鞘内化疗治疗新确诊的IVLBCL的疗效和安全性

2020-03-17 MedSci原创 MedSci原创

IVLBCL；R-CHOP;甲氨蝶呤；利妥昔单抗
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对于无明显CNS累及的IVLBCL患者来说，R-CHOP联合利妥昔单抗和大剂量甲氨蝶呤+鞘内化疗是一种可耐受的有效的治疗方式.

血管内大B细胞淋巴瘤(IVLBCL)是一种罕见病，目前尚无可用的标准治疗。

PRIMEUR-IVL研究是一个多中心的、单臂的、2期临床试验，旨在评估R-CHOP（利妥昔单抗、环磷酰胺、阿霉素、长春新碱和泼尼松龙）联合大剂量甲氨蝶呤和鞘内化疗作为CNS导向的治疗方案对未治疗过的IVLBCL患者的安全性和活性。招募20-79岁的未治疗过的病理明确诊断的、确诊时无明显CNS累及的的IVLBCL患者。先予以三个疗程的R-CHOP，然后再予以两个疗程的利妥昔单抗和大剂量甲氨蝶呤，最后再予以三个额外的R-CHOP疗程。主要结点是2年无进展存活率。

2011年6月16日-2016年7月21日，共招募了38位患者，1位患者因睾丸淋巴瘤病史被排除，最终37位符合要求。中位随访3.9年（IQR 2.5-5.5）。2年无进展存活率位76%（95% CI 58-87）。最常见的3-4级不良反应有中性粒细胞减少和白细胞减少（见于所有患者）。重度不良反应为低钾血症、发热性中性粒细胞减少合并低血压、高血压和颅内出血（各1例[3%]）。无治疗相关死亡。

对于无明显CNS累及的IVLBCL患者来说，R-CHOP联合利妥昔单抗和大剂量甲氨蝶呤+鞘内化疗是一种可耐受的有效的治疗方式，值得进一步进行研究。

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    2020-11-03 howi

    #Lancet#

    0

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    2020-10-09 经常头晕

    #疗效和安全性#

    0

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    2021-01-05 ms7258648636991762

    #LBCL#

    0

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    2021-02-11 minlingfeng

    #Oncol#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1830526, encodeId=2c061830526bd, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Nov 03 16:05:08 CST 2020, time=2020-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1720940, encodeId=126c1e2094090, content=<a href='/topic/show?id=634ee040179' target=_blank style='color:#2F92EE;'>#疗效和安全性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70401, encryptionId=634ee040179, topicName=疗效和安全性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16ef32982072, createdName=经常头晕, createdTime=Fri Oct 09 23:05:08 CST 2020, time=2020-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2021248, encodeId=8702202124897, content=<a href='/topic/show?id=a80f10e3046' target=_blank style='color:#2F92EE;'>#LBCL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10730, encryptionId=a80f10e3046, topicName=LBCL)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/XhttJCp4Aq9gKA5n4v9elclQlVQTDenMiaEiadlI5D3gtmfSiaicoIY4ZsuibrQKLibDdxBKVY8oS6B2FicqJlT93clow/132, createdBy=03202500144, createdName=ms7258648636991762, createdTime=Tue Jan 05 12:05:08 CST 2021, time=2021-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1865804, encodeId=a1d218658040e, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Thu Feb 11 21:05:08 CST 2021, time=2021-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1456594, encodeId=def314565948d, content=<a href='/topic/show?id=f76e15029a7' target=_blank style='color:#2F92EE;'>#R-CHOP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15029, encryptionId=f76e15029a7, topicName=R-CHOP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Thu Mar 19 11:05:08 CST 2020, time=2020-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032447, encodeId=21ac103244e02, content=谢谢梅斯提供这么好的信息，学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Tue Mar 17 23:05:08 CST 2020, time=2020-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038004, encodeId=36cb10380043a, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Tue Mar 17 23:05:08 CST 2020, time=2020-03-17, status=1, ipAttribution=)]
    2020-03-19 智智灵药

    #R-CHOP#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1830526, encodeId=2c061830526bd, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Nov 03 16:05:08 CST 2020, time=2020-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1720940, encodeId=126c1e2094090, content=<a href='/topic/show?id=634ee040179' target=_blank style='color:#2F92EE;'>#疗效和安全性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70401, encryptionId=634ee040179, topicName=疗效和安全性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16ef32982072, createdName=经常头晕, createdTime=Fri Oct 09 23:05:08 CST 2020, time=2020-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2021248, encodeId=8702202124897, content=<a href='/topic/show?id=a80f10e3046' target=_blank style='color:#2F92EE;'>#LBCL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10730, encryptionId=a80f10e3046, topicName=LBCL)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/XhttJCp4Aq9gKA5n4v9elclQlVQTDenMiaEiadlI5D3gtmfSiaicoIY4ZsuibrQKLibDdxBKVY8oS6B2FicqJlT93clow/132, createdBy=03202500144, createdName=ms7258648636991762, createdTime=Tue Jan 05 12:05:08 CST 2021, time=2021-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1865804, encodeId=a1d218658040e, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Thu Feb 11 21:05:08 CST 2021, time=2021-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1456594, encodeId=def314565948d, content=<a href='/topic/show?id=f76e15029a7' target=_blank style='color:#2F92EE;'>#R-CHOP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15029, encryptionId=f76e15029a7, topicName=R-CHOP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Thu Mar 19 11:05:08 CST 2020, time=2020-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032447, encodeId=21ac103244e02, content=谢谢梅斯提供这么好的信息，学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Tue Mar 17 23:05:08 CST 2020, time=2020-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038004, encodeId=36cb10380043a, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Tue Mar 17 23:05:08 CST 2020, time=2020-03-17, status=1, ipAttribution=)]
    2020-03-17 内科新手

    谢谢梅斯提供这么好的信息，学到很多

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1830526, encodeId=2c061830526bd, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Nov 03 16:05:08 CST 2020, time=2020-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1720940, encodeId=126c1e2094090, content=<a href='/topic/show?id=634ee040179' target=_blank style='color:#2F92EE;'>#疗效和安全性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70401, encryptionId=634ee040179, topicName=疗效和安全性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16ef32982072, createdName=经常头晕, createdTime=Fri Oct 09 23:05:08 CST 2020, time=2020-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2021248, encodeId=8702202124897, content=<a href='/topic/show?id=a80f10e3046' target=_blank style='color:#2F92EE;'>#LBCL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10730, encryptionId=a80f10e3046, topicName=LBCL)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/XhttJCp4Aq9gKA5n4v9elclQlVQTDenMiaEiadlI5D3gtmfSiaicoIY4ZsuibrQKLibDdxBKVY8oS6B2FicqJlT93clow/132, createdBy=03202500144, createdName=ms7258648636991762, createdTime=Tue Jan 05 12:05:08 CST 2021, time=2021-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1865804, encodeId=a1d218658040e, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Thu Feb 11 21:05:08 CST 2021, time=2021-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1456594, encodeId=def314565948d, content=<a href='/topic/show?id=f76e15029a7' target=_blank style='color:#2F92EE;'>#R-CHOP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15029, encryptionId=f76e15029a7, topicName=R-CHOP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Thu Mar 19 11:05:08 CST 2020, time=2020-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032447, encodeId=21ac103244e02, content=谢谢梅斯提供这么好的信息，学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Tue Mar 17 23:05:08 CST 2020, time=2020-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038004, encodeId=36cb10380043a, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Tue Mar 17 23:05:08 CST 2020, time=2020-03-17, status=1, ipAttribution=)]
    2020-03-17 anti-cancer

    谢谢梅斯分享这么多精彩信息

    0