Rituximab对治疗低分化十二直肠淋巴瘤有效[英文]
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Rituximab May Offer Effective Treatment for Low Grade Duodenal Lymphoma
Rituximab appears to be a promising treatment option for duodenal low-grade lymphoma refractory to standard therapy, producing a high response rate in a short period of time with minimal toxicity, according to a new case study.
Duodenal lymphoma is rare, and has a poor prognosis due to the critical location of neoplasms and the advanced stage of disease at diagnosis. Despite intensive treatment with combination chemotherapy, disease recurrence is frequent and a majority of patients remain incurable with a limited quality of life.
A possible alternative to conventional chemotherapy is monoclonal antibody therapy, which delivers the cytotoxic effect directly to the cancer cell. Previous studies have demonstrated that response rates in patients with chemotherapy-refractory low-grade non-Hodgkin lymphoma treated with rituximab, a CD-20 monoclonal antibody, to be 48%.
In a recently published report, Shazia Ahmed, M.D., and colleagues of St. Joseph Mercy Hospital in Ann Arbor, Michigan, United States, report a case of lymphoma refractory to combination chemotherapy, and later treated successfully with rituximab.
The patient was a 35-year-old woman who presented with complaints of lower extremity swelling which had persisted for a year. Laboratory evaluation revealed a microcytic anaemia with iron deficiency and hypoalbuminaemia, and endoscopy revealed multiple 2- to 3-mm nodules in the duodenum. Biopsy results showed malignant, low-grade, small B-cell type lymphoma.
After 6 cycles of cyclophosphamide, vincristine, and prednisone, a repeat esophagogastroduodenoscopy (EGD) with biopsy again showed multiple 2- to 3-mm nodules in the duodenum positive for malignant lymphoma. The patient was then treated with 4 weekly doses of rituximab at 375 mg/m2.
A repeat EGD and biopsy 4 months later showed white papules in the duodenum with no signs of lymphoma, and the patient continued to test negative for lymphoma for 2 years into follow up.
"Given the excellent clinical response to rituximab demonstrated by this patient, future studies should assess the use of rituximab as first-line therapy for low-grade lymphoma of the duodenum," the researchers concluded.
Am J Clin Oncol 2003 Aug;26:4:408-10., http://www.100md.com
Rituximab appears to be a promising treatment option for duodenal low-grade lymphoma refractory to standard therapy, producing a high response rate in a short period of time with minimal toxicity, according to a new case study.
Duodenal lymphoma is rare, and has a poor prognosis due to the critical location of neoplasms and the advanced stage of disease at diagnosis. Despite intensive treatment with combination chemotherapy, disease recurrence is frequent and a majority of patients remain incurable with a limited quality of life.
A possible alternative to conventional chemotherapy is monoclonal antibody therapy, which delivers the cytotoxic effect directly to the cancer cell. Previous studies have demonstrated that response rates in patients with chemotherapy-refractory low-grade non-Hodgkin lymphoma treated with rituximab, a CD-20 monoclonal antibody, to be 48%.
In a recently published report, Shazia Ahmed, M.D., and colleagues of St. Joseph Mercy Hospital in Ann Arbor, Michigan, United States, report a case of lymphoma refractory to combination chemotherapy, and later treated successfully with rituximab.
The patient was a 35-year-old woman who presented with complaints of lower extremity swelling which had persisted for a year. Laboratory evaluation revealed a microcytic anaemia with iron deficiency and hypoalbuminaemia, and endoscopy revealed multiple 2- to 3-mm nodules in the duodenum. Biopsy results showed malignant, low-grade, small B-cell type lymphoma.
After 6 cycles of cyclophosphamide, vincristine, and prednisone, a repeat esophagogastroduodenoscopy (EGD) with biopsy again showed multiple 2- to 3-mm nodules in the duodenum positive for malignant lymphoma. The patient was then treated with 4 weekly doses of rituximab at 375 mg/m2.
A repeat EGD and biopsy 4 months later showed white papules in the duodenum with no signs of lymphoma, and the patient continued to test negative for lymphoma for 2 years into follow up.
"Given the excellent clinical response to rituximab demonstrated by this patient, future studies should assess the use of rituximab as first-line therapy for low-grade lymphoma of the duodenum," the researchers concluded.
Am J Clin Oncol 2003 Aug;26:4:408-10., http://www.100md.com